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肾移植术后由人类疱疹病毒6B引起的胰腺脑炎

Encephalitis caused by human herpesvirus-6B in pancreas-after-kidney transplantation.

作者信息

Yamamoto T, Watarai Y, Goto N, Horikoshi Y, Yamada S, Yasui K, Tsujita M, Hiramitsu T, Narumi S, Katayama A, Uchida K, Kobayashi T

机构信息

Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan; Department of Transplant Immunology, Nagoya University School of Medicine, Nagoya, Japan.

出版信息

Transpl Infect Dis. 2014 Oct;16(5):853-8. doi: 10.1111/tid.12270. Epub 2014 Jul 21.

Abstract

Human herpesvirus-6 (HHV-6) is a common pathogen among children, classically presenting with fever and rash that resolves without specific therapy. HHV-6 can be reactivated in the immunosuppressed patient. After bone marrow and solid organ transplantation, HHV-6 has been linked to various clinical syndromes, including undifferentiated febrile illness, encephalitis, myelitis, hepatitis, pneumonitis, and bone marrow suppression. However, HHV-6 encephalitis after pancreatic transplant has rarely been reported. Early diagnosis and treatment of HHV-6 encephalitis may be important for affected patients. We report the case of a 53-year-old pancreas-after-kidney transplant recipient who initially presented with high fever and confusion 3 weeks after operation. We managed to save the patient's life and preserve the pancreas graft function. We also review previously reported cases of HHV-6B encephalitis in solid organ transplant recipients.

摘要

人类疱疹病毒6型(HHV-6)是儿童常见的病原体,典型表现为发热和皮疹,无需特殊治疗即可自行消退。HHV-6可在免疫抑制患者中重新激活。在骨髓和实体器官移植后,HHV-6与多种临床综合征有关,包括不明原因的发热性疾病、脑炎、脊髓炎、肝炎、肺炎和骨髓抑制。然而,胰腺移植后HHV-6脑炎鲜有报道。早期诊断和治疗HHV-6脑炎对受影响的患者可能很重要。我们报告了一例53岁的肾后胰腺移植受者,术后3周最初出现高热和意识模糊。我们成功挽救了患者的生命并保留了胰腺移植功能。我们还回顾了先前报道的实体器官移植受者中HHV-6B脑炎的病例。

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