title: [Acute lymphoblastic leukemia complicated with varicella zoster virus meningoencephalitis and visceral dissemination after related bone marrow transplantation].
abstract: Meningitis or encephalitis by varicella-zoster virus (VZV) after hematopoietic stem cell transplantation (HSCT) is rarely reported. We encountered a case of meningoencephalitis with VZV re-activation 18 months after related bone marrow transplantation for recurrent acute lymphoblastic leukemia. The patient had been administered steroid and cyclosporine for chronic graft-versus-host disease. A high DNA copy number of VZV, 4.9×10(7) copies was detected in the cerebrospinal fluid. VZV also caused severe pneumonia and acute renal failure soon after the onset of meningoencephalitis. The patient was successfully treated with acyclovir, although he was left with persistent neurological sequelae. Both prompt diagnosis and early treatment of VZV reactivation are important to avoid a fatal outcome.
authors.affiliation: Department of Pediatrics, National Kyushu Cancer Center, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Teranishi
authors.forename: Michiyo
authors.initials: M
authors.lastname: Sakiyama
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nagatoshi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nomura
authors.forename: Jiro
authors.initials: J
authors.lastname: Inagaki
authors.forename: Fumio
authors.initials: F
authors.lastname: Yanai
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002908:Chronic Disease; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D020804:Encephalitis, Varicella Zoster / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D011014:Pneumonia / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy*; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D013997:Time Factors; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D000212:Acyclovir