Human herpesvirus-6 encephalitis after unrelated umbilical cord blood transplant in children

Bone Marrow Transplant. 2002 Jun;29(12):991-4. doi: 10.1038/sj.bmt.1703596.

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 pruritus, 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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / administration & dosage
  • Child
  • Cord Blood Stem Cell Transplantation / adverse effects*
  • DNA, Viral / blood
  • Encephalitis, Viral / diagnosis
  • Encephalitis, Viral / drug therapy
  • Encephalitis, Viral / etiology*
  • Female
  • Herpesvirus 6, Human*
  • Humans
  • Leukemia / complications
  • Leukemia / therapy
  • Male
  • Retrospective Studies
  • Roseolovirus Infections / diagnosis
  • Roseolovirus Infections / drug therapy
  • Roseolovirus Infections / etiology*
  • Transplantation, Homologous / adverse effects
  • Treatment Outcome

Substances

  • Antiviral Agents
  • DNA, Viral