@article {DegotP2690, author = {Tristan Degot and Alexandre Leclercq and Anne Gairard-Dory and Alexandre Saula and Sandrine Hirschi and Armelle Schuller and Benjamin Renaud-Picard and Benedicte Gourieux and Romain Kessler}, title = {Oral human serum immunoglobulin for norovirus diarrhea in pulmonary transplant patients}, volume = {42}, number = {Suppl 57}, elocation-id = {P2690}, year = {2013}, publisher = {European Respiratory Society}, abstract = {Viral and particularly Norovirus-induced diarrhea is generally a limited disease but becomes prolonged and severe in transplant patients. No effective therapeutic agents is currently available. Oral human serum immunoglobulin has been previously used in patients with viral diarrhea with clinical improvement.A retrospective study in our transplantation center evaluated the management of Norovirus diarrhea in pulmonary transplant patients. Clinical, biological data and treatments of patients who developed Norovirus diarrhea between 2009 and 2012 were recorded. Indications for transplantation were emphysema and idiopathic fibrosis.The prevalence of Norovirus diarrhea was 4.3\% (6/140) with 6 patients who developed 8 gastroenteritis. Diarrhea occurred between 18th month and 4th years after transplantation. Norovirus ELISA-test was positive in stools but needed sometimes repeated analysis (up to 5 times). 1 patient developed a co infection with Enterocytozoon bieneusi. Diarrhea frequency was 5 to 10 per day and duration was at least 1 week. 4 patients developed acute renal insufficiency and 2 patients experienced hyperkaliemia induced by deshydration. Diarrhea symptoms were not modified by reduction of immunosuppression. Oral human serum immunoglobulin was administered at 25 mg/kg every 6 or 8 hour for 2 days. Diarrhea resolved 2 to 3 days after treatment initiation. No side effects were reported. Late onset of viral enteritis did not seem to be related to the level of immunosuppression.This study is the first description of Norovirus enteritis in pulmonary transplantation. The fast resolution of the diarrhea after oral human serum immunoglobulin was similar to results described in case reports.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P2690}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P2690.full.pdf}, journal = {European Respiratory Journal} }