title: [Macrophage activation syndrome in primary human herpes virus-6 infection: a rare condition after liver transplantation in infants].
abstract: Human herpes virus-6 primary infection generally occurs during the first three years of childhood and is generally asymptomatic. The virus has been identified as the causal agent of exanthemum subitum in children or mononucleosis-like disease in adults, and may also cause several disorders in immunocompromised patients. We report a clinical case of acute rejection observed 29 days after orthotopic liver transplantation in a 22-month-old child associated with acute hepatitis and a hemophagocytic syndrome on day 38. Human herpes virus-6 primary infection was identified based on several virological tests: seroconversion, detection of viral DNA in bone marrow and peripheral blood after polymerase chain reaction, and detection of viral replication in peripheral blood. Tests for Epstein-Barr virus, cytomegalovirus or Parvovirus B19 infections were negative. After treatment by ganciclovir (Cymévan(R)), clinical status improved.
authors.affiliation: Unité de Virologie, Service de Microbiologie, Hôpital de Bicêtre, 78, rue de Général-Leclerc, Assistance-Publique Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre Cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Lecointe
authors.forename: M
authors.initials: M
authors.lastname: Fabre
authors.forename: D
authors.initials: D
authors.lastname: Habes
authors.forename: F
authors.initials: F
authors.lastname: Mielot
authors.forename: O
authors.initials: O
authors.lastname: Bernard
authors.forename: P
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000208:Acute Disease; D000998:Antiviral Agents / Q000627:therapeutic use; D005077:Exanthema Subitum / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection / Q000276:immunology*; D015654:Herpesvirus 6, Human; D015616:Histiocytosis, Non-Langerhans-Cell / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008262:Macrophage Activation / Q000276:immunology*
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir