PMID: 8590772Aug 1, 1995Paper

Successful intravenous immunoglobulin therapy for severe and persistent astrovirus gastroenteritis after fludarabine treatment in a patient with Waldenström's macroglobulinemia

International Journal of Hematology
M BjörkholmJ Waldenström

Abstract

A 78-year-old male with Waldenström's macroglobulinemia was after 23 years of conservative treatment given fludarabine phosphate in 1993 because of disease progression. Three weeks after the third fludarabine course he presented with a 5-day-history of watery diarrhoea, nausea and vomiting. Stool cultures were negative but a semiquantitative electron microscopy method demonstrated massive amounts of astrovirus (> 10(14) particles/ml). Symptomatic treatment was given but since his condition deteriorated, high-dose intravenous immunoglobulin (IvIg) treatment, 0.4 g/kg for four days was initiated. Within twenty-four hours all symptoms disappeared and the patient was discharged after a few days. A stool sample collected after two weeks demonstrated 10(7) particles/ml and after four weeks no astrovirus could be detected. The association between fludarabine and this opportunistic infection and the potential role of high dose IvIg treatment are discussed.

Citations

Oct 29, 2002·Leukemia & Lymphoma·Morie A Gertz
Aug 26, 2003·Journal of Medical Virology·Santiago CaballeroAlbert Bosch
Oct 15, 2003·Journal of Virology·Matthew D KociStacey Schultz-Cherry
Apr 2, 2005·Viral Immunology·Lindsey A Moser, Stacey Schultz-Cherry
Aug 4, 2007·British Journal of Haematology·Rafael Fonseca, Suzanne Hayman
Jan 13, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Samia N NaccacheCharles Y Chiu
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Jan 15, 2004·Journal of Virology·Matthew D KociStacey Schultz-Cherry
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Mar 22, 2006·Seminars in Hematology·Anthony D Ho, Manfred Hensel
May 24, 2016·ACS Infectious Diseases·Walter A BogdanoffRebecca M DuBois

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