Successful Treatment of Fulminant Hepatitis due to Varicella Zoster Virus using Immunoglobulin in a Kidney Transplant Patient
- Author:
Li Chang HSING
1
;
Ji Yeun KIM
;
Ji Soo KWON
;
Eui Cheol SHIN
;
Sung Han KIM
Author Information
- Publication Type:Case Report
- From:Infection and Chemotherapy 2019;51(3):310-314
- CountryRepublic of Korea
- Language:English
- 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.
