MacLean Heather J, Douen Andre G
Division of Neurology, The Ottawa Hospital, General Campus, University of Ottawa, Ottawa, Ontario, K1H 8L6 Canada.
Transplantation. 2002 Apr 15;73(7):1086-9. doi: 10.1097/00007890-200204150-00012.
Human herpesvirus 6 (HHV-6) appears to have a predilection for immunocompromised patients and has been implicated as a cause of posttransplant encephalitis. However, the pathogenesis, as well as the appropriate means of diagnosis and treatment of HHV-6 encephalitis is unclear.
We describe a case of a 20-year-old male university student with anemia who presented with an acute, severe amnesia 1 month after bone marrow transplantation. His illness was subsequently attributed to HHV-6 encephalitis.
Cerebrospinal fluid analysis was consistent with encephalitis and polymerase chain reaction confirmed the presence of HHV-6 DNA in both cerebrospinal fluid and serum. No other herpes virus particles were detected. MRI showed bilateral hippocampal involvement. Treatment with acyclovir resulted in a decrease in serum HHV-6 DNA to undetectable levels, coincident with improvement of both memory and lesions on MRI.
This case provides strong clinical and radiological evidence of the reversibility of this disease process and supports the recommendations for empiric treatment of post transplant patients with laboratory evidence of HHV-6 infection, culture or polymerase chain reaction, plus clinical symptoms compatible with HHV-6 infection.
人类疱疹病毒6型（HHV - 6）似乎对免疫功能低下的患者具有偏好性，并被认为是移植后脑炎的病因之一。然而，HHV - 6脑炎的发病机制以及合适的诊断和治疗方法尚不清楚。
我们描述了一例20岁患贫血的男性大学生病例，该患者在骨髓移植后1个月出现急性、严重失忆症状。其病情随后被归因于HHV - 6脑炎。
脑脊液分析与脑炎相符，聚合酶链反应证实脑脊液和血清中均存在HHV - 6 DNA。未检测到其他疱疹病毒颗粒。MRI显示双侧海马体受累。使用阿昔洛韦治疗后，血清HHV - 6 DNA降至检测不到的水平，同时记忆和MRI上的病灶均有所改善。
该病例为这一疾病过程的可逆性提供了有力的临床和影像学证据，并支持对有HHV - 6感染实验室证据（培养或聚合酶链反应）且伴有与HHV - 6感染相符临床症状的移植后患者进行经验性治疗的建议。
