[CIS PIDD] [cis-pidd] CVID and norovirus

[Seppänen Mikko]

Dear all,

on this list, the problems of CVID patients with norovirus pop up time to time, but very regularly.

In our cohort, it is the biggest clinical problem (and enteropathy is a serious harbinger of early death in CVIDs in general) together with granulomatous inflammation. And both are extremely frustrating to treat.

I thought I would "advertise" the following article (with which personally I have nothing to do) by the Cambridge group, since it escaped my radar for over 6 months. Maybe there are others on the list as unperceptive as I have been?

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Am J Gastroenterol.<http://www.ncbi.nlm.nih.gov/pubmed/25623655> 2015 Feb;110(2):320-7. doi: 10.1038/ajg.2014.432. Epub 2015 Jan 27.
The role of chronic norovirus infection in the enteropathy associated with common variable immunodeficiency.
Woodward JM<http://www.ncbi.nlm.nih.gov/pubmed/?term=Woodward%20JM%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>1, Gkrania-Klotsas E<http://www.ncbi.nlm.nih.gov/pubmed/?term=Gkrania-Klotsas%20E%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>2, Cordero-Ng AY<http://www.ncbi.nlm.nih.gov/pubmed/?term=Cordero-Ng%20AY%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>3, Aravinthan A<http://www.ncbi.nlm.nih.gov/pubmed/?term=Aravinthan%20A%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>4, Bandoh BN<http://www.ncbi.nlm.nih.gov/pubmed/?term=Bandoh%20BN%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>5, Liu H<http://www.ncbi.nlm.nih.gov/pubmed/?term=Liu%20H%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>5, Davies S<http://www.ncbi.nlm.nih.gov/pubmed/?term=Davies%20S%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>5, Zhang H<http://www.ncbi.nlm.nih.gov/pubmed/?term=Zhang%20H%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>3, Stevenson P<http://www.ncbi.nlm.nih.gov/pubmed/?term=Stevenson%20P%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>6, Curran MD<http://www.ncbi.nlm.nih.gov/pubmed/?term=Curran%20MD%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>3, Kumararatne D<http://www.ncbi.nlm.nih.gov/pubmed/?term=Kumararatne%20D%5BAuthor%5D&cauthor=true&cauthor_uid=25623655>6.

----------------------

Interestingly, it suggests that fecal PCR is not sensitive enough and that one should use tissue-PCR in (all) CVID enteropathy patients...

They reached clearance in 2/8 patients with ribavirin monotherapy, but our patients seem very resistant (all = riba, riba+IF, as well as nitazoxanide in combination with the other agents tried in our most severe case).

QUESTIONS:
Do people already share the experience of Cambridge group:

a)      has anyone else tested tissue-PCR OR

b)      therapy in their cohorts (which you are not about to publish)?

If you already know the article, apologies for an unnecessary intrusion!

Curious,



Mikko Seppänen
oyl Mikko Seppänen
Harvinaissairauksien yksikkö (HAKE), HUS

Mikko Seppänen, MD, PhD, Associate professor
Specialist in Internal Medicine and Infectious Diseases
Chief, Rare Disease Center, Helsinki University Hospital (HUH)
Children's Hospital, P.O.Box 280
FI-00029 HUS
FINLAND
&
Senior Consultant (PIDD)
Adult Immunodeficiency Unit
Inflammation Center, HUH

phone +358 9 47180201
GSM +358 50 4279606
fax +359 9 47174703




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