Prolonged sinus tachycardia caused by human herpesvirus 6 (HHV6) encephalomyelitis after allogeneic bone marrow transplantation.
A 19-year-old man with Philadelphia chromosome-positive acute lymphoblastic leukemia received an allogeneic hematopoietic cell transplant with unrelated bone marrow. On day 20, the patient developed impaired consciousness and disorientation. Examination of the cerebrospinal fluid showed 2×10(4) copies/mL of HHV6B. HHV6 encephalitis was diagnosed, as had HHV6 myelitis based on symptoms that included lancinating pain/pruritus in the lower limbs and dysuria/dyschezia. Concurrently, he showed sinus tachycardia. Even after clearance of the HHV6 genome from the plasma and CSF was achieved by treatment with foscarnet, sinus tachycardia persisted for another 100 days. We suspected prolonged sinus tachycardia due to dysautonomia caused by HHV6 encephalomyelitis.
Hematology, Graduate School of Medicine, Osaka City University, Japan.
Mitsutaka
M
Nishimoto
Hirohisa
H
Nakamae
Yoshiki
Y
Hayashi
Hideo
H
Koh
Takahiko
T
Nakane
Masahiro
M
Yoshida
Masato
M
Bingo
Hiroshi
H
Okamura
Mizuki
M
Aimoto
Satoru
S
Nanno
Takuro
T
Yoshimura
Akiko
A
Inaba
Kiyoyuki
K
Hagihara
Mika
M
Nakamae
Asao
A
Hirose
Yoshitaka
Y
Nakao
Yoshiki
Y
Terada
Masayuki
M
Hino
D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D018792:Encephalitis, Viral / Q000188:drug therapy / Q000209:etiology*; D017245:Foscarnet / Q000627:therapeutic use; D015654:Herpesvirus 6, Human; D006801:Humans; D008297:Male; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy; D019349:Roseolovirus Infections / Q000188:drug therapy / Q000209:etiology*; D013616:Tachycardia, Sinus / Q000209:etiology*; D014184:Transplantation, Homologous; D055815:Young Adult
D000998:Antiviral Agents; D017245:Foscarnet