gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Convalescent plasma for treatment of severe pandemic influenza A (H1N1) 2009 infection

Rekonvaleszentenplasma zur Behandlung von schweren Influenza A (H1N1) Infektionen

Meeting Abstract

  • G. Härter - Sektion Infektiologie und Klinische Immunologie, Comprehensive Infectious Diseases Center (CIDC), Ulm, Germany
  • M. Wiesneth - Institut für Klinische Transfusionsmedizin und Immungenetik Ulm (IKT Ulm), Ulm, Germany
  • T. Mertens - Institut für Virologie, Comprehensive Infectious Diseases Center (CIDC), Ulm, Germany
  • A. Schubert - Institut für Virologie, Comprehensive Infectious Diseases Center (CIDC), Ulm, Germany
  • O. Zimmermann - Klinik für Innere Medizin II, Zentrum für Innere Medizin, Ulm, Germany
  • J. Wöhrle - Klinik für Innere Medizin II, Zentrum für Innere Medizin, Ulm, Germany
  • P. Kern - Sektion Infektiologie und Klinische Immunologie, Comprehensive Infectious Diseases Center (CIDC), Ulm, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP109

DOI: 10.3205/10kit164, URN: urn:nbn:de:0183-10kit1642

Published: June 2, 2010

© 2010 Härter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Transfusions of influenza A (H5N1) convalescent plasma containing specific antibodies were reported to reduce mortality in patients with severe influenza pneumonia. Here we describe one patient with a severe pandemic influenza A (H1N1) pneumonitis receiving therapeutic transfusions of H1N1 influenza-convalescent plasma.

Methods: Convalescent fresh frozen plasma was obtained by whole blood donation and plasmapheresis from two healthy donors who had recovered from a pandemic influenza A (H1N1) 2009 infection 3 months before donation. Convalescent plasma was given to one patient at high risk of lethal complications of influenza A (H1N1) infection. Diagnosis of pandemic influenza A (H1N1) 2009 infection was confirmed by specific real time RT-PCR.

Results: A 52-year-old female patient with a history of diabetes mellitus II, hypertension, and obesity suffered from fever, cough and myalgias for 3 days. Due to progression to acute respiratory distress syndrome the patient was admitted to our hospital and invasive mechanical ventilation became necessary. After diagnosis of pandemic influenza A (H1N1) 2009 infection by RT-PCR in bronchoalveolar fluid antiviral treatment with oral oseltamivir 150 mg b.i.d. was started. Due to concerns regarding absorption of oseltamivir in the critically ill patient, intravenous zanamivir 600 mg b.i.d. was initiated and continued for 7 days. Because of clinical deterioration and poor ventilation an interventional lung assist (ILA) was implanted, and 400 ml of convalescent plasma was given within 8 hours. Viral RNA in respiratory material became undetectable rapidly after 3 days. The patient could be extubated after clinical improvement.

Conclusions: Passive immunotherapy with specific anti-influenza antibodies containing convalescent plasma obtained from donors with previous pandemic (H1N1) 2009 influenza A virus infection may be a therapeutic option in severe cases. It has been used successfully in patients with influenza A (H5N1) infection. Our case showed a rapid clinical improvement and viral clearance of pandemic (H1N1) 2009 influenza virus and points to a potential therapeutic option using convalescent plasma.