一例伴有基因组病毒DNA整合的双侧人类疱疹病毒6型全葡萄膜炎病例。
A case of bilateral human herpes virus 6 panuveitis with genomic viral DNA integration.
作者信息
Bajric Jasmina, Smith Wendy M
机构信息
Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester 55905, MN, USA.
出版信息
J Ophthalmic Inflamm Infect. 2014 Jun 19;4:16. doi: 10.1186/s12348-014-0016-x. eCollection 2014.
BACKGROUND
We report a rare case of bilateral panuveitis from human herpes virus 6 (HHV-6) with genomic viral DNA integration in an immunocompromised man.
FINDINGS
A 59-year-old man with history of multiple myeloma presented with altered mental status, bilateral eye redness, and blurry vision. Examination revealed bilateral diffuse keratic precipitates, 4+ anterior chamber cell, hypopyon, vitritis, and intraretinal hemorrhages. Intraocular fluid testing by polymerase chain reaction (PCR) was positive for HHV-6. The patient was successfully treated with intravitreal foscarnet and intravenous ganciclovir and foscarnet. Despite clinical improvement, his serum HHV-6 levels remained high, and it was concluded that he had HHV-6 chromosomal integration.
CONCLUSIONS
HHV-6 should be considered in the differential for infectious uveitis in immunocompromised hosts who may otherwise have a negative work-up. HHV-6 DNA integration may lead to difficulties in disease diagnosis and determining disease resolution.
背景
我们报告了一例罕见的人类疱疹病毒6型（HHV-6）引起的双侧葡萄膜炎病例，该病例发生在一名免疫功能低下的男性身上，病毒基因组DNA发生了整合。
研究结果
一名有多发性骨髓瘤病史的59岁男性出现精神状态改变、双眼发红和视力模糊。检查发现双侧弥漫性角膜后沉着物、4+前房细胞、前房积脓、玻璃体炎和视网膜内出血。通过聚合酶链反应（PCR）进行的眼内液检测显示HHV-6呈阳性。患者接受玻璃体内膦甲酸和静脉注射更昔洛韦及膦甲酸治疗后成功康复。尽管临床症状有所改善，但其血清HHV-6水平仍居高不下，结论是他发生了HHV-6染色体整合。
结论
对于免疫功能低下宿主的感染性葡萄膜炎鉴别诊断，应考虑HHV-6，否则这些患者的检查结果可能为阴性。HHV-6 DNA整合可能导致疾病诊断困难以及难以确定疾病是否痊愈。
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