Incidence and clinical manifestations of adenoviral infection among children undergoing allogeneic stem cell transplantation

Moshe Ephros, Bat Chen Friedman, Ronit Elhasid, Zipi Kra-Oz, Pninit Shaked-Mishan, Judith Sattinger, Imad Kassis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Adenoviral infection in children undergoing stem cell transplantation is associated with significant morbidity and mortality. Identification of adenoviral infection by polymerase chain reaction from blood facilitates accurate and rapid diagnosis and surveillance. The incidence of adenoviral infection among children undergoing SCT in Israel is not known. Objective: To estimate the incidence of adenoviral infection in pediatric SCT patients and to characterize the morbidity associated with proven infection. Methods: Blood samples obtained weekly from children who underwent allogeneic SCT were retrospectively tested for adenovirus using standard PCR. A total of 657 samples collected from 32 patients were examined. Correlation was made between the presence of adenovirus in samples and clinical records. Results: Of the 32 patients 4 had adenoviral infection by PCR (12.5%). Clinical disease was present in all four patients concurrent with positive PCR. Gastrointestinal complaints and abnormal hepatocellular enzymes were uniformly present. One patient died due to disseminated disease. T cell depletion was a significant risk factor for adenoviral infection (P = 0.03). Conclusions: In the patient population studied, the incidence of adenoviral infection in children undergoing SCT was 12.5%. The combination of gastrointestinal symptoms and abnormal hepatocellular enzymes should raise the suspicion of adenoviral infection, especially when occurring during the first few months after SCT.

Original languageEnglish
Pages (from-to)744-748
Number of pages5
JournalIsrael Medical Association Journal
Volume11
Issue number12
StatePublished - Dec 2009
Externally publishedYes

Keywords

  • Adenovirus
  • Immunosuppression
  • Polymerase chain reaction
  • Stem cell transplantation
  • T cell depletion

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