Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2000-5-12
pubmed:abstractText
We report here a patient who suffered from PCR- confirmed human herpesvirus type 6 (HHV-6) meningoencephalitis after allogeneic purified CD34+ cell transplantation from his HLA-mismatched sibling donor, even though he had been on intense prophylaxis with i.v. ganciclovir (GCV), acyclovir (ACV) and gamma-globulin containing a specific antibody against HHV-6. Serological evaluation disclosed that both the donor and recipient had IgG antibody against HHV-6 before transplantation. His blood WBC count started to transiently increase on day 10, and all blood components had decreased by day 20. He then developed a severe headache and high blood pressure, and sporadic abnormal neurological findings including nystagmus and delirium. An analysis of cerebrospinal fluid (CSF) revealed 8 cells/microl, a glucose level of 130 mg/dl and a protein level of 201 mg/dl (normal, 50 mg/dl) on day 26. At the time, HHV-6 was detected only in CSF by a PCR-based method and he was diagnosed as having meningoencephalitis due to the local reactivation of HHV-6. Although he failed to respond to high-dose therapy with ACV (60 mg/kg/day) and gamma-globulin, the DNA of this virus disappeared from the CNS upon treatment with GCV (30 mg/kg/day) combined with the intraventricular infusion of alpha-interferon. His clinical course was further complicated with meningoencephalitis due to staphylococcus epidermidis, and he died of tentorial herniation on day 79 without the recovery of blood components. This experience may indicate that intense prophylaxis to prevent reactivation of HHV-6 in the CNS is essential for the management of such profoundly immunosuppressed patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0268-3369
pubmed:author
pubmed:issnType
Print
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
787-90
pubmed:dateRevised
2005-11-17
pubmed:meshHeading
pubmed-meshheading:10745266-Acyclovir, pubmed-meshheading:10745266-Adolescent, pubmed-meshheading:10745266-Anemia, Aplastic, pubmed-meshheading:10745266-Antigens, CD, pubmed-meshheading:10745266-Antigens, CD34, pubmed-meshheading:10745266-Antiviral Agents, pubmed-meshheading:10745266-Drug Therapy, Combination, pubmed-meshheading:10745266-Ganciclovir, pubmed-meshheading:10745266-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:10745266-Herpesviridae Infections, pubmed-meshheading:10745266-Herpesvirus 6, Human, pubmed-meshheading:10745266-Histocompatibility Testing, pubmed-meshheading:10745266-Humans, pubmed-meshheading:10745266-Magnetic Resonance Imaging, pubmed-meshheading:10745266-Male, pubmed-meshheading:10745266-Meningoencephalitis, pubmed-meshheading:10745266-Polymerase Chain Reaction, pubmed-meshheading:10745266-Virus Diseases, pubmed-meshheading:10745266-gamma-Globulins
pubmed:year
2000
pubmed:articleTitle
HLA-mismatched CD34-selected stem cell transplant complicated by HHV-6 reactivation in the central nervous system.
pubmed:affiliation
Department of Pediatrics, University of Tokushima, Tokushima, Japan.
pubmed:publicationType
Journal Article, Case Reports