Abstract
Three children developed human herpesvirus-6 (HHV-6), variant B encephalitis after unrelated umbilical cord blood transplant, in a single center. They developed clinical manifestations of encephalitis around day 17 post transplant. Impairment of consciousness, incoherent speech, episodic focal pruritis, motor weakness, convulsions and severe hyponatremia were features at presentation. Radiological investigation of brain ranged from unremarkable to extensive white matter and meningeal lesions. Diagnosis was established by the presence of HHV-6 DNA in cerebrospinal fluid (CSF). Retrospective analyses of plasma revealed the presence of viral DNAemia prior to the onset of disease in two subjects. Treatment with ganciclovir or foscarnet was given. Two subjects did not achieve engraftment and died of other transplant-related complications on day 38 and 56 post-transplant, respectively. One subject achieved disease-free survival for more than 1 year with a satisfactory neurological outcome. In conclusion, HHV-6 encephalitis is not uncommon among patients undergoing umbilical cord blood transplantation. It is worth conducting further studies on early diagnosis and optimal management of this potentially fatal disease.
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References
Levy JA . Three new human herpesviruses (HHV6, 7 and 8) Lancet 1997 349: 558 562
Singh N, Paterson D . Encephalitis caused by human herpesvirus-6 in transplant recipients: relevance of a novel neurotropic virus Transplantation 2000 69: 2474 2479
Iguchi A, Kobayashi R, Yoshida M et al. Neurological complications after stem cell transplantation in childhood Bone Marrow Transplant 1999 24: 647 652
Chan PKS, Ng HK, Hui M, Cheng AF . Prevalence and distribution of human herpesvirus 6 variants A and B in adult human brain J Med Virol 2001 64: 42 46
Gluckman E . Current status of umbilical cord blood hematopoietic stem cell transplantation Exp Hematol 2000 28: 1197 1205
Cone RW, Huang MW, Corey L et al. Human herpesvirus 6 infections after bone marrow transplantation: clinical and virologic manifestations J Infect Dis 1999 179: 311 318
Imbert-Marcille BM, Tang XW, Lepelletier D et al. Human herpesvirus 6 infection after autologous or allogeneic stem cell transplantation: a single center prospective longitudinal study of 92 patients Clin Infect Dis 2000 31: 881 886
Wang FZ, Linde A, Hagglund H et al. Human herpesvirus 6 DNA in cerebrospinal fluid specimens from allogeneic bone marrow transplant patients: does it have clinical significance? Clin Infect Dis 1999 28: 562 568
Bosi A, Zazzi M, Amantini A et al. Fatal herpesvirus 6 encephalitis after unrelated bone marrow transplant Bone Marrow Transplant 1998 22: 285 288
Drobyski WR, Knox KK, Majewski D, Carrigan DR . Fatal encephalitis due to variant B human herpesvirus-6 infection in a bone marrow-transplant recipient New Engl J Med 1994 330: 1356 1360
Kawano Y, Miyazaki T, Watanabe T et al. HLA-mismatched CD34-selected stem cell transplant complicated by HHV-6 reactivation in the central nervous system Bone Marrow Transplant 2000 25: 787 790
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Chik, K., Chan, P., Li, C. et al. Human herpesvirus-6 encephalitis after unrelated umbilical cord blood transplant in children. Bone Marrow Transplant 29, 991–994 (2002). https://doi.org/10.1038/sj.bmt.1703596
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DOI: https://doi.org/10.1038/sj.bmt.1703596
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