Human herpesvirus 6 infection and transient acquired myelodysplasia in children.
BACKGROUND
To demonstrate that primary human herpesvirus 6 (HHV-6) infection in childhood can cause hematopoietic dysplasia that mimics a myelodysplastic syndrome (MDS) in severe cases.


METHODS
Seven immunocompetent children, who presented at admission with concomitant cytopenias in blood and morphologic features of dysplasia in bone marrow, were evaluated. Diagnosis of acute HHV-6 infection was secondary made by detection of HHV-6 DNA in plasma, bone marrow, or cerebrospinal fluid and measurement of plasma antibody titers. Peripheral blood and bone marrow aspirate smears were examined at diagnosis and during follow-up. Morphologic recognition of myelodysplasia was made according to the recommendations of the Third MIC Cooperative Group.


RESULTS
Anemia was the most frequent cytopenia (five of seven cases). Bi- or tri-lineage dysplasia was observed in the marrow samples. Granulocytic and erythroid cells were always affected with dysgranulopoiesis and dyserythropoiesis scores equal to or higher than 3. Myelodysplasia was not due to a clonal disorder and disappeared gradually within 1 or 2 months.


CONCLUSIONS
Our results indicate that severe HHV-6 infection may induce reversible myelodysplastic changes. These findings contribute to elucidate the pathogenicity of HHV-6 and furthermore suggest that HHV-6 infection must also be considered as a cause of dysplasia in the differential diagnosis of MDS.
Kagialis-Girard
Sandrine
S
Hematology Laboratory, Hôpital Debrousse, Hospices Civils de Lyon, and Hematology Laboratory, Faculty of Pharmacy, Claude Bernard University, Lyon, France. sandrine.girard@chu-lyon.fr
Durand
Brigitte
B
Mialou
Valérie
V
Pagès
Marie-Pierre
MP
Galambrun
Claire
C
Bertrand
Yves
Y
Negrier
Claude
C
D000208:Acute Disease; D000293:Adolescent; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D002675:Child, Preschool; D015897:Comorbidity; D003289:Convalescence; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D019349:Roseolovirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome