Norovirus gastroenteritis causes severe and lethal complications after chemotherapy and hematopoietic stem cell transplantation by Stefan Schwartz, Maria.

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Norovirus gastroenteritis causes severe and lethal complications after chemotherapy and hematopoietic stem cell transplantation by Stefan Schwartz, Maria Vergoulidou, Eckart Schreier, Christoph Loddenkemper, Mark Reinwald, Martin Schmidt-Hieber, Willy A. Flegel, Eckhard Thiel, and Thomas Schneider Blood Volume 117(22):5850-5856 June 2, 2011 ©2011 by American Society of Hematology

Kaplan-Meier curves showing the disease duration in NV GE Kaplan-Meier curves showing the disease duration in NV GE. The symptom durations in 11 patients and 11 staff members with NV gastroenteritis are displayed. Kaplan-Meier curves showing the disease duration in NV GE. The symptom durations in 11 patients and 11 staff members with NV gastroenteritis are displayed. Stefan Schwartz et al. Blood 2011;117:5850-5856 ©2011 by American Society of Hematology

Abdominal CT scan of a patient with NV GE Abdominal CT scan of a patient with NV GE. Extensive bowel edema in a patient with NV GE acquired during BEAM conditioning chemotherapy for autologous HSCT. The bowel wall edema was restricted to the small intestine, and the colon showed only a moderate dil... Abdominal CT scan of a patient with NV GE. Extensive bowel edema in a patient with NV GE acquired during BEAM conditioning chemotherapy for autologous HSCT. The bowel wall edema was restricted to the small intestine, and the colon showed only a moderate dilation. Stefan Schwartz et al. Blood 2011;117:5850-5856 ©2011 by American Society of Hematology

Sequential duodenal biopsies from a patient with allogeneic HSCT Sequential duodenal biopsies from a patient with allogeneic HSCT. (A) Duodenal biopsy with severe GVHD showing partial loss of surface epithelium (H&E) and increased numbers of apoptotic crypt epithelial cells (inset: cleaved caspase-3 staining showing apop... Sequential duodenal biopsies from a patient with allogeneic HSCT. (A) Duodenal biopsy with severe GVHD showing partial loss of surface epithelium (H&E) and increased numbers of apoptotic crypt epithelial cells (inset: cleaved caspase-3 staining showing apoptotic epithelial cells at the base of crypts). (B) Predominance of CD8+ T cells in the lamina propria with focal infiltration of the crypt epithelium (immunohistochemistry, APAAP method). (C) In contrast, duodenal biopsy in the same patient during NV infection shows villous blunting (H&E) and only a slight increase of apoptotic epithelial cells at the tip of the villi (inset: cleaved caspase-3) and (D) a massive increase of intraepithelial CD8+ T cells pronounced in the surface epithelium. Original magnifications, ×200 and ×600 (inset). Microscope: Olympus AX70 (Olympus); numeric aperture of objective lenses: ×20, 0.70 mm; ×60, 1.40. Stains: H&E (panels A and C); APAAP and streptavidin AP (panels B and D, inset). Camera: JVC KY-F70 (JVC); acquisition software: DISKUS; and software used for image processing: Adobe Photoshop 7.0 (Adobe Systems). Stefan Schwartz et al. Blood 2011;117:5850-5856 ©2011 by American Society of Hematology