Language

English

Publication Date

1-1-2022

Journal

Cell Transplantation

DOI

10.1177/09636897221119734

PMID

36927092

PMCID

PMC9478732

PubMedCentral® Posted Date

9-14-2022

PubMedCentral® Full Text Version

Post-print

Abstract

A patient with an ultimate diagnosis of human herpesvirus-6 (HHV-6) encephalitis developed central nervous system (CNS) symptoms 13 days after undergoing myeloablative haploidentical allogeneic hematopoietic stem cell transplant (HSCT). Due to the patient's body habitus, magnetic resonance (MR) imaging was not obtained until the onset of retrograde amnesia on day +24. MR imaging and other clinical findings eliminated all skepticism of HHV-6 encephalitis and HHV-6 antivirals were initiated on day +28, leading to gradual recovery. This case demonstrates some of the factors that may complicate the diagnosis of post-alloHSCT HHV-6 encephalitis. Because HHV-6 encephalitis and viremia can occur without warning, a single negative study should not exclude future development, especially if CNS symptoms are present. Acute graft-versus-host disease and cord blood transplantation are both significant risk factors for HHV-6 encephalitis. Human leukocyte antigen (HLA) mismatch, engraftment complications, or certain HLA alleles have also been associated with HHV-6 encephalitis. Chromosomally integrated HHV-6 must also be ruled out to prevent inappropriate and potentially harmful administration of antivirals. Due to the severe short- and long-term sequelae of HHV-6 encephalitis, appropriate treatment should be administered as soon as possible.

Keywords

Humans, Herpesvirus 6, Human, Antiviral Agents, Graft vs Host Disease, Roseolovirus Infections, Encephalitis, Viral, Hematopoietic Stem Cell Transplantation, human herpesvirus-6, encephalitis, hematopoietic stem cell transplant, amnesia, HHV-6, reactivation

Published Open-Access

yes

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