title: Successful treatment of life-threatening human herpesvirus-6 encephalitis with donor lymphocyte infusion in a patient who had undergone human leukocyte antigen-haploidentical nonmyeloablative stem cell transplantation.
abstract: BACKGROUND
  Encephalitis as the result of human herpesvirus (HHV)-6 is usually fatal when it is resistant to antiviral drugs.
  
  
  METHODS
  We describe a patient who developed HHV-6 encephalitis after human leukocyte antigen-haploidentical transplantation using a reduced intensity regimen.
  
  
  RESULTS
  The patient developed severe disorientation, amnesia, and tremors on day 28. Magnetic resonance imaging of the brain revealed limbic encephalitis, and the cerebrospinal fluid sample was positive for only HHV-6 in polymerase chain reaction analysis. Neither ganciclovir nor foscarnet was effective. The patient recovered from the critical condition of HHV-6 encephalitis after donor lymphocyte infusion (DLI). Almost all of his symptoms resolved, polymerase chain reaction tests for HHV-6 in the cerebrospinal fluid were negative, and magnetic resonance imaging findings were normal.
  
  
  CONCLUSIONS
  This is the first report of DLI as a treatment for HHV-6 encephalitis and the first report of DLI from an human leukocyte antigen-haploidentical donor as a treatment for life-threatening viral infection.
authors.affiliation: Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshihara
authors.forename: Ruri
authors.initials: R
authors.lastname: Kato
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inoue
authors.forename: Hiromi
authors.initials: H
authors.lastname: Miyagawa
authors.forename: Junji
authors.initials: J
authors.lastname: Sashihara
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ikegame
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Oka
authors.forename: Haruo
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology / Q000821:virology; D018792:Encephalitis, Viral / Q000628:therapy*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology*; D015654:Herpesvirus 6, Human; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017710:Lymphocyte Transfusion; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D019349:Roseolovirus Infections / Q000276:immunology* / Q000628:therapy*; D033581:Stem Cell Transplantation; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens; D007166:Immunosuppressive Agents; D016559:Tacrolimus