Abstract
The clinical benefit of adjuvant intravenous immunoglobulin (IVIG) therapy is controversial in immunocompromised patients with severe varicella. A twenty-one-year-old woman who had received a kidney transplant one year earlier presented with fever and generalized rash for 5 days. Initial immunoglobulin M (IgM) and IgG for varicella zoster virus (VZV) were negative; however, the patient was diagnosed with varicella with fulminant hepatitis because VZV-specific PCR from skin vesicles and blood was positive. The patient received intravenous acyclovir and 5-day IVIG. The decline of plasma viral load was steeper (beta coefficient −0.446) during IVIG therapy than after the therapy (beta coefficient −0.123) (P = 0.04), while VZV glycoprotein IgG titers and VZV-specific T cell responses were not detected during the 5-day IVIG therapy. The patient improved without any complications. This case provides an experimental evidence that adjuvant IVIG can significantly reduce viral load in immunocompromised patients with severe varicella.
| Original language | English |
|---|---|
| Pages (from-to) | 310-314 |
| Number of pages | 5 |
| Journal | Infection and Chemotherapy |
| Volume | 51 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2019 |
Keywords
- Fatal hepatitis
- Intravenous immunoglobulin
- Varicella zoster virus
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Hsing, L. C., Kim, J. Y., Kwon, J. S., Shin, E. C., & Kim, S. H. (2019). Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient. Infection and Chemotherapy, 51(3), 310-314. https://doi.org/10.3947/ic.2019.51.3.310
Hsing, Li Chang ; Kim, Ji Yeun ; Kwon, Ji Soo et al. / Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient. In: Infection and Chemotherapy. 2019 ; Vol. 51, No. 3. pp. 310-314.
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title = "Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient",
abstract = "The clinical benefit of adjuvant intravenous immunoglobulin (IVIG) therapy is controversial in immunocompromised patients with severe varicella. A twenty-one-year-old woman who had received a kidney transplant one year earlier presented with fever and generalized rash for 5 days. Initial immunoglobulin M (IgM) and IgG for varicella zoster virus (VZV) were negative; however, the patient was diagnosed with varicella with fulminant hepatitis because VZV-specific PCR from skin vesicles and blood was positive. The patient received intravenous acyclovir and 5-day IVIG. The decline of plasma viral load was steeper (beta coefficient −0.446) during IVIG therapy than after the therapy (beta coefficient −0.123) (P = 0.04), while VZV glycoprotein IgG titers and VZV-specific T cell responses were not detected during the 5-day IVIG therapy. The patient improved without any complications. This case provides an experimental evidence that adjuvant IVIG can significantly reduce viral load in immunocompromised patients with severe varicella.",
keywords = "Fatal hepatitis, Intravenous immunoglobulin, Varicella zoster virus",
author = "Hsing, {Li Chang} and Kim, {Ji Yeun} and Kwon, {Ji Soo} and Shin, {Eui Cheol} and Kim, {Sung Han}",
note = "Publisher Copyright: {\textcopyright} 2019 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.",
year = "2019",
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language = "English",
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Hsing, LC, Kim, JY, Kwon, JS, Shin, EC & Kim, SH 2019, 'Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient', Infection and Chemotherapy, vol. 51, no. 3, pp. 310-314. https://doi.org/10.3947/ic.2019.51.3.310
Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient. / Hsing, Li Chang; Kim, Ji Yeun; Kwon, Ji Soo et al.
In: Infection and Chemotherapy, Vol. 51, No. 3, 2019, p. 310-314.
Research output: Contribution to journal › Article › peer-review
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AU - Hsing, Li Chang
AU - Kim, Ji Yeun
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AU - Shin, Eui Cheol
AU - Kim, Sung Han
N1 - Publisher Copyright:© 2019 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
PY - 2019
Y1 - 2019
N2 - The clinical benefit of adjuvant intravenous immunoglobulin (IVIG) therapy is controversial in immunocompromised patients with severe varicella. A twenty-one-year-old woman who had received a kidney transplant one year earlier presented with fever and generalized rash for 5 days. Initial immunoglobulin M (IgM) and IgG for varicella zoster virus (VZV) were negative; however, the patient was diagnosed with varicella with fulminant hepatitis because VZV-specific PCR from skin vesicles and blood was positive. The patient received intravenous acyclovir and 5-day IVIG. The decline of plasma viral load was steeper (beta coefficient −0.446) during IVIG therapy than after the therapy (beta coefficient −0.123) (P = 0.04), while VZV glycoprotein IgG titers and VZV-specific T cell responses were not detected during the 5-day IVIG therapy. The patient improved without any complications. This case provides an experimental evidence that adjuvant IVIG can significantly reduce viral load in immunocompromised patients with severe varicella.
AB - The clinical benefit of adjuvant intravenous immunoglobulin (IVIG) therapy is controversial in immunocompromised patients with severe varicella. A twenty-one-year-old woman who had received a kidney transplant one year earlier presented with fever and generalized rash for 5 days. Initial immunoglobulin M (IgM) and IgG for varicella zoster virus (VZV) were negative; however, the patient was diagnosed with varicella with fulminant hepatitis because VZV-specific PCR from skin vesicles and blood was positive. The patient received intravenous acyclovir and 5-day IVIG. The decline of plasma viral load was steeper (beta coefficient −0.446) during IVIG therapy than after the therapy (beta coefficient −0.123) (P = 0.04), while VZV glycoprotein IgG titers and VZV-specific T cell responses were not detected during the 5-day IVIG therapy. The patient improved without any complications. This case provides an experimental evidence that adjuvant IVIG can significantly reduce viral load in immunocompromised patients with severe varicella.
KW - Fatal hepatitis
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Hsing LC, Kim JY, Kwon JS, Shin EC, Kim SH. Successful treatment of fulminant hepatitis due to varicella zoster virus using immunoglobulin in a kidney transplant patient. Infection and Chemotherapy. 2019;51(3):310-314. doi: 10.3947/ic.2019.51.3.310
