[Unilateral uveitis with HHV6-positive polymerase chain reaction in aqueous humor for an etanercept-treated woman: a case report].
Human herpesvirus 6 is a ubiquitous Herpesviridae infecting patients during childhood. Its role in ocular disorders is mostly unknown. We report the case of a 47-year-old woman with a history of rheumatoid arthritis (treated with etanercept) and tuberculosis, who presented with sudden unilateral panuveitis. The patient was initially treated with ganciclovir, as the polymerase chain reaction in the aqueous humor was positive for HHV6, and with pyrimethamine and sulfadiazine because a toxoplasmic co-infection was highly suspected, which was biologically confirmed. Management of HHV6 in a nervous system disorder is challenging because its replication has been proved but its role remains unclear. HHV6 may be pathogenic by itself but can facilitate co-infection as can etanercept.
Glâtre
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Service d'ophtalmologie, pôle de médecine interne-ophtalmologie-ORL, CHU Gabriel-Montpied, 58, boulevard Montalembert, 63003 Clermont-Ferrand, France. fglatre@yahoo.fr
Rousseau
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Bacin
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D018501:Antirheumatic Agents / Q000009:adverse effects*; D001082:Aqueous Humor / Q000821:virology*; D000068800:Etanercept; D005260:Female; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018124:Receptors, Tumor Necrosis Factor; D019349:Roseolovirus Infections; D014605:Uveitis / Q000821:virology*
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept