Document Detail


Successful treatment of life-threatening human herpesvirus-6 encephalitis with donor lymphocyte infusion in a patient who had undergone human leukocyte antigen-haploidentical nonmyeloablative stem cell transplantation.
MedLine Citation:
PMID:  15077022     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Encephalitis as the result of human herpesvirus (HHV)-6 is usually fatal when it is resistant to antiviral drugs. METHODS: We describe a patient who developed HHV-6 encephalitis after human leukocyte antigen-haploidentical transplantation using a reduced intensity regimen. RESULTS: The patient developed severe disorientation, amnesia, and tremors on day 28. Magnetic resonance imaging of the brain revealed limbic encephalitis, and the cerebrospinal fluid sample was positive for only HHV-6 in polymerase chain reaction analysis. Neither ganciclovir nor foscarnet was effective. The patient recovered from the critical condition of HHV-6 encephalitis after donor lymphocyte infusion (DLI). Almost all of his symptoms resolved, polymerase chain reaction tests for HHV-6 in the cerebrospinal fluid were negative, and magnetic resonance imaging findings were normal. CONCLUSIONS: This is the first report of DLI as a treatment for HHV-6 encephalitis and the first report of DLI from an human leukocyte antigen-haploidentical donor as a treatment for life-threatening viral infection.
Authors:
Satoshi Yoshihara; Ruri Kato; Takayuki Inoue; Hiromi Miyagawa; Junji Sashihara; Manabu Kawakami; Kazuhiro Ikegame; Yoshihiro Oka; Haruo Sugiyama; Ichiro Kawase; Hiroyasu Ogawa
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  77     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-04-12     Completed Date:  2004-05-05     Revised Date:  2005-02-25    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  835-8     Citation Subset:  IM    
Affiliation:
Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain / pathology,  virology
Encephalitis, Viral / therapy*
Graft vs Host Disease / prevention & control
HLA Antigens / immunology*
Herpesvirus 6, Human*
Histocompatibility Testing
Humans
Immunosuppressive Agents / therapeutic use
Lymphocyte Transfusion*
Lymphoma, B-Cell / pathology,  therapy
Magnetic Resonance Imaging
Male
Roseolovirus Infections / immunology*,  therapy*
Stem Cell Transplantation*
Tacrolimus / therapeutic use
Tissue Donors
Chemical
Reg. No./Substance:
0/HLA Antigens; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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