title: Detection of human herpesvirus 6 and JC virus in progressive multifocal leukoencephalopathy complicating follicular lymphoma.
abstract: Progressive multifocal leukoencephalopathy (PML), a demyelinating infectious disease caused by JC virus (JCV), occurs almost exclusively in immunocompromised patients usually with malignant diseases. We report here a Japanese female with follicular lymphoma who subsequently developed PML. In addition to JCV, human herpesvirus 6 (HHV-6) was detected in the affected brain lesions of the patient by polymerase chain reaction and by in situ hybridization. HHV-6, recognized as a neurotropic virus, is known to be reactivated during immunosuppression and can cause fatal complications such as encephalitis/encephalopathy. It is likely that impaired immunity associated with lymphoma and the additional immunosuppression following cytopenia-inducing chemotherapies predisposed the patient to reactivated HHV-6 infection. Although it remains to be clarified whether HHV-6 plays an important role as a co-agent with JCV in causing demyelination of the brain, our observation alerts physicians to the possible association of HHV-6 with the pathogenesis of PML.
authors.affiliation: Department of Medicine, Kochi Medical School, Kochi, Japan. daibatam@kochi-ms.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Daibata
authors.forename: N
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: M
authors.initials: M
authors.lastname: Kamioka
authors.forename: Y
authors.initials: Y
authors.lastname: Nemoto
authors.forename: M
authors.initials: M
authors.lastname: Hiroi
authors.forename: I
authors.initials: I
authors.lastname: Miyoshi
authors.forename: H
authors.initials: H
authors.lastname: Taguchi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D001921:Brain / Q000473:pathology / Q000821:virology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004279:DNA, Viral / Q000302:isolation & purification; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications / Q000821:virology*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification* / Q000472:pathogenicity / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D016867:Immunocompromised Host; D007577:JC Virus / Q000302:isolation & purification* / Q000472:pathogenicity / Q000502:physiology; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology / Q000473:pathology / Q000821:virology*; D008224:Lymphoma, Follicular / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009607:Nitrosourea Compounds / Q000008:administration & dosage / Q000009:adverse effects; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology*; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D016133:Polymerase Chain Reaction; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D016879:Salvage Therapy; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D014751:Vindesine / Q000008:administration & dosage / Q000009:adverse effects; D014775:Virus Activation
chemical_list: D004279:DNA, Viral; D009607:Nitrosourea Compounds; D010879:Piperazines; D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D008942:Mitoxantrone; C057773:sobuzoxane; D014751:Vindesine; C020766:ranimustine