The preceding hyponatremia is a useful hallmark for the diagnosis of HHV-6 encephalitis after allogeneic hematopoietic stem cell transplantation

Yoshida, Shota; Ara, Takahide; Okada, Ken-ichi; Mori, Yuichi; Tsukamoto, Shihori; Miyashita, Naoki; Kasahara, Keiji; Ebata, Ko; Iwasaki, Junko; Takahashi, Shojiro; Shigematsu, Akio; Minauchi, Koichiro; Kobayashi, Naoki; Ogasawara, M.; Imamura, Masahiro; Teshima, Takanori; Ota, Shuichi

doi:10.1038/s41409-022-01843-y

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…11,12 It has also been suggested that preexisting hyponatremia may also be a potential marker for predicting HHV-6 encephalitis in adults after HSCT. 13 In our study, four patients with HHV-6 encephalitis developed intractable hyponatremia during the course of the disease, and the decrease in serum sodium levels all preceded the onset of encephalitis by 1-2 days. The exact mechanism by which SIADH associated with HHV-6 encephalitis causes hyponatremia remains to be determined.…”

Section: Discussionmentioning

confidence: 50%

"Unusual" viral diseases after allogeneic hematopoietic stem cell transplantation: a multicenter, retrospective study

Lin,

Wu,

Zhang

et al. 2023

Preprint

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Objective To observe the risk factors, clinical features, diagnosis and treatment, and prognosis of "unusual" viral diseases except "common" viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV) under the background of allogeneic hematopoietic stem cell transplantation dominated by haploidentical transplantation; to explore the optimal detection strategy for rare viruses. Method From April 2018 to June 2023, the "uncommon" virus disease cases other than CMV and EBV diagnosed in 3 transplant centers in China: the First Affiliated Hospital of Soochow University, the Second People's Hospital of Huai'an and the Affiliated People's Hospital of Ningbo University were retrospectively observed and analyzed. Result There were 10 cases of human adenovirus (HAdV) virus diseases, 7 cases of human herpesvirus 6 (HHV-6) virus diseases and 2 cases of human parvovirus B19 (HPV-B19) virus diseases. Up to the end of follow-up, 1 in 10 HAdV patients had survived and 9 had died, 8 of them died from viral infection and 1 died from recurrence of the primary disease. Of the 7 patients with HHV-6 virus, 6 survived and 1 died from recurrence of the primary disease. Of 2 patients with HPV-B19 virus, 1 survived and 1 died of HPV-B19 pneumonia. Conclusion CD3+T cells < 300 /ul, GVHD, ATG, the use of CD25 monoclonal antibody, pre-transplant chimeric antigen receptor T-Cell immunotherapy (CAR-T) or blinatumomab treatment history: may increase the risk of "unusual" viral disease; Pathogenic metagenomic next-generation sequencing(mNGS) of organ-specific samples has the best detection efficiency and can provide information about virus subtypes. The prognosis of HAdV-C infection and HPV-B19 systemic infection is poor, which should be paid more attention to, and high-risk patients should be screened as early as possible.

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Section: Discussionmentioning

confidence: 50%

"Unusual" viral diseases after allogeneic hematopoietic stem cell transplantation: a multicenter, retrospective study

Lin,

Wu,

Zhang

et al. 2023

Preprint

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“…Hyponatremia has been reported to be the most common electrolyte imbalance in patients receiving allogeneic HCT 30 . The possible causes of hyponatremia after allogeneic HCT are likely multifactorial, including vomiting, diarrhea, intravenous fluids and medications, renal dysfunction, GVHD, sinusoidal obstruction syndrome, syndrome of inappropriate secretion of antidiuretic hormone, and human herpesvirus (HHV)-6 encephalitis 30 – 35 . Although CBT has been reported to be a risk factor for the development of HHV-6 encephalitis 36 , no patients in our cohort developed HHV-6 encephalitis.…”

Section: Discussionmentioning

confidence: 99%

Low urinary sodium-to-potassium ratio in the early phase following single-unit cord blood transplantation is a predictive factor for poor non-relapse mortality in adults

Takano,

Monna-Oiwa,

Isobe

et al. 2024

Sci Rep

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Although daily higher urinary sodium (Na) and potassium (K) excretion ratio is associated with the risk of cardiovascular disease in the general population, a low Na/K ratio is associated with renal dysfunction in critically ill patients. Thus, we retrospectively analyzed the impact of daily urinary Na and K excretion and their ratio on non-relapse mortality (NRM) and overall mortality in 172 adult single-unit cord blood transplantation (CBT) patients treated at our institution between 2007 and 2020. Multivariate analysis showed that a low urinary Na/K ratio at both 14 days (hazard ratio [HR], 4.82; 95% confidence interval [CI], 1.81–12.83; P = 0.001) and 28 days (HR, 4.47; 95% CI 1.32–15.12; P = 0.015) was significantly associated with higher NRM. Furthermore, a low urinary Na/K ratio at 28 days was significantly associated with higher overall mortality (HR, 2.38; 95% CI 1.15–4.91; P = 0.018). Patients with a low urinary Na/K ratio had decreased urine volume, more weight gain, experienced more grade III–IV acute graft-versus-host disease, and required corticosteroids by 28 days after CBT. These findings indicate that a low urinary Na/K ratio early after single-unit CBT is associated with poor NRM and survival in adults.

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Renal Complications Following Hematopoietic Stem Cell Transplantation

Tanase,

Andronesi,

Lipan

et al. 2024

Stem Cell Transplantation [Working Title]

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Renal complications following hematopoietic stem cell transplantation (HSCT) pose substantial clinical challenges and impact patient outcomes. This chapter provides an in-depth analysis of the renal complications that may arise post-HSCT, including acute kidney injury (AKI), nephrotic syndrome, chronic kidney disease (CKD), and electrolyte imbalances. These complications occur from various factors such as nephrotoxic medications, graft-versus-host-disease (GVHD), infections, and pre-existing renal conditions. Early identification and management of renal dysfunction are crucial for optimizing patient care and prognosis. The chapter underscores the importance of vigilant monitoring, supportive measures, and timely interventions to mitigate renal complications post-HSCT. Enhanced understanding of these complications empowers clinicians to implement targeted preventive strategies and personalized therapeutic interventions, ultimately enhancing the overall outcomes and quality of life for HSCT recipients.

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The preceding hyponatremia is a useful hallmark for the diagnosis of HHV-6 encephalitis after allogeneic hematopoietic stem cell transplantation

Cited by 3 publications

References 12 publications

"Unusual" viral diseases after allogeneic hematopoietic stem cell transplantation: a multicenter, retrospective study

"Unusual" viral diseases after allogeneic hematopoietic stem cell transplantation: a multicenter, retrospective study

Low urinary sodium-to-potassium ratio in the early phase following single-unit cord blood transplantation is a predictive factor for poor non-relapse mortality in adults

Renal Complications Following Hematopoietic Stem Cell Transplantation

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