An Adult Case of Relapsing Human Herpesvirus-6 Encephalitis

Sawada, Jun; Nakatani-Enomoto, Setsu; Aizawa, Hitoshi; Katayama, Takayuki; Ito, Takashi; Aburakawa, Yoko; Kikuchi, Kenjiro

doi:10.2169/internalmedicine.46.0239

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…The high frequency of HHV-6 DNA detection in the CSF of encephalitis patients is consistent with a number of recent studies14, 17–20, 31 that suggest a possible role of HHV-6 in neurological complications. To extend the significance of this observation, we asked whether host immune response against HHV-6 could also be detected in the CSF of encephalitis patients with unknown etiology.…”

Section: Resultssupporting

confidence: 90%

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Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Yao

Honarmand²,

Espinosa³

et al. 2009

Annals of Neurology

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Objective Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. Over 150 different viruses have been implicated in the pathogenesis of encephalitis, however due to limitations with diagnostic testing, etiologies of over half of the cases remain unknown. Methods To investigate whether HHV-6 is an etiological agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using PCR and assessed HHV-6 antibody reactivity in the cerebrospinal fluids (CSF) of encephalitis patients with unknown etiology. In a cohort study, we compared virus specific antibody levels in CSF samples of patients with encephalitis, relapsing-remitting MS and other neurologic diseases (OND). Results Our results demonstrated elevated levels of HHV-6 IgG as well as IgM levels in a subset of encephalitis patients compared with OND. Moreover, cell-free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, while no amplifiable viral sequence was found in either relapsing-remitting MS or OND patients. Additionally, a significant correlation between PCR detection and anti-HHV-6 antibody response was also demonstrated. Interpretation Collectively, these results suggested HHV-6 as a possible pathogen in a subset of encephalitis cases.

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Section: Resultssupporting

confidence: 90%

“…In some patients, high viral load as well as antibodies against HHV-6 could be demonstrated in the CSF of these patients. Collectively, these studies highlight the role of HHV-6 as a pathogenic agent in CNS diseases 17–19, 31…”

Section: Introductionmentioning

confidence: 87%

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Yao

Honarmand²,

Espinosa³

et al. 2009

Annals of Neurology

View full text Add to dashboard Cite

show abstract

“…The high frequency of HHV‐6 DNA detection in the CSF of encephalitis patients is consistent with a number of recent studies14, 17–20, 31 that suggest a possible role of HHV‐6 in neurological complications. To extend the significance of this observation, we asked whether host immune response against HHV‐6 could also be detected in the CSF of patients with encephalitis of unknown cause.…”

Section: Resultssupporting

confidence: 90%

“…In some patients, high viral load and antibodies against HHV‐6 could be demonstrated in the cerebrospinal fluid (CSF) of these patients. Collectively, these studies highlight the role of HHV‐6 as a pathogenic agent in CNS diseases 17–19, 31…”

mentioning

confidence: 88%

Combination of paclitaxel and carboplatin as second‐line therapy for patients with metastatic melanoma

Rao

Holtan

Ingle

et al. 2005

Cancer

110

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Objective Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. More than 150 different viruses have been implicated in the pathogenesis of encephalitis; however, because of limitations with diagnostic testing, causative factors of more than half of the cases remain unknown. Methods To investigate whether human herpesvirus‐6 (HHV‐6) is a causative agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using polymerase chain reaction and assessed HHV‐6 antibody reactivity in the cerebrospinal fluid of encephalitis patients with unknown cause. In a cohort study, we compared virus‐specific antibody levels in cerebrospinal fluid samples of patients with encephalitis, relapsing‐remitting multiple sclerosis, and other neurological diseases. Results Our results demonstrated increased levels of HHV‐6 IgG, as well as IgM levels, in a subset of encephalitis patients compared with other neurological diseases. Moreover, cell‐free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, whereas no amplifiable viral sequence was found in either relapsing‐remitting MS or other neurological diseases patients. In addition, a significant correlation between polymerase chain reaction detection and anti‐HHV‐6 antibody response was also demonstrated. Interpretation Collectively, these results suggested HHV‐6 as a possible pathogen in a subset of encephalitis cases. Ann Neurol 2009;65:257–267

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“…Researchers recently described a case of relapsing encephalitis attributed to HHV-6 in an apparently immunocompetent 73-year-old woman; the symptoms occurred twice over a 3-year period, with the initial presentation characterized by disturbance of consciousness and tonicclonic seizures [ 40 ]. In support of a possible connection to HHV-6, serology obtained during the two episodes demonstrated 80-fold and 320-fold increases in serum HHV-6 IgG titers.…”

Section: Hhv-6-associated Encephalitis In the Immunocompetent Patientmentioning

confidence: 99%

Human herpesvirus 6 encephalitis

Gewurz¹,

Marty²,

Baden³

et al. 2008

Curr Infect Dis Rep

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Human herpesvirus (HHV) 6, the etiologic agent of roseola, is nearly universally acquired during childhood. The virus establishes lifelong infection, including within the central nervous system (CNS), and replicates within several CNS cell types. HHV-6 has been linked to CNS disease during primary infection, including febrile seizures and possibly hippocampal injury. HHV-6 may also be associated with neurologic disease later in life, particularly in transplant patients. Recent reports offer evidence that HHV-6 reactivation may underlie a characteristic limbic encephalitis syndrome following hematopoietic cell transplant; the cardinal features of this syndrome include memory loss, insomnia, electroencephalographic evidence of temporal lobe seizure activity, MRI signal intensity abnormalities of the mesial temporal lobe, and the syndrome of inappropriate release of antidiuretic hormone. HHV-6 DNA is frequently detectable by nucleic acid amplification tests in the cerebrospinal fluid and peripheral blood upon symptom onset, which may provide a screening strategy in high-risk patients. Possible associations of HHV-6 with meningoencephalitis, mesial temporal lobe epilepsy, and multiple sclerosis in apparently immunocompetent hosts are under investigation.

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An Adult Case of Relapsing Human Herpesvirus-6 Encephalitis

Abstract: Human

Cited by 12 publications

References 26 publications

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Combination of paclitaxel and carboplatin as second‐line therapy for patients with metastatic melanoma

Human herpesvirus 6 encephalitis

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