EBV limbic encephalitis after allogenic hematopoietic stem cell transplantation.
The clinical and radiological presentations of Epstein-Barr virus (EBV) encephalitis are pleomorphic, but a common and characteristic finding is an increased T2-weighted signal in the bilateral thalami and basal ganglia. We report here a case of post-transplant acute limbic encephalitis (PALE) syndrome that was possibly related to EBV infection. Six weeks after hematopoietic stem-cell transplantation, the patient developed confusion and anterograde amnesia. Brain magnetic resonance imaging (MRI) was performed and revealed bi-hippocampal and amygdala signal abnormalities. The technetium-99m single-photon emission computed tomography ((99m)Tc SPECT) imaging confirmed bilateral limbic structural involvement. The clinical, biological and radiological presentations were consistent with a diagnosis of EBV-induced PALE syndrome. To our knowledge, this is the first described case of PALE syndrome possibly related to EBV infection.
Kremer
Stéphane
S
UMR-7191 (LINC), service de radiologie 2, hôpital Hautepierre, université de Strasbourg, CHU de Strasbourg, Strasbourg, France. stephane.kremer@chru-strasbourg.fr
Matern
Jean-François
JF
Bilger
Karin
K
Lioure
Bruno
B
Fornecker
Yves
Y
Stoll-Keller
Françoise
F
Namer
Izzie-Jacques
IJ
Dietemann
Jean-Louis
JL
Fafi-Kremer
Samira
S
D000679:Amygdala / Q000473:pathology; D000741:Anemia, Aplastic / Q000628:therapy; D001284:Atrophy; D004292:Dominance, Cerebral / Q000502:physiology; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis*; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D020363:Limbic Encephalitis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis*; D013788:Thalamus / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon