[Epileptic encephalopathy associated with human herpes virus 6 (HHV-6) encephalitis after the second cord blood transplantation in a patient with pediatric acute lymphoblastic leukemia].
The incidence of HHV-6 encephalitis during hematopoietic stem cell transplantation (HSCT) in children is thought to be less than that in adults and risk factors, prognosis and complications are virtually unknown. Herein, we report a pediatric case developing epileptic encephalopathy following HHV-6 encephalitis after a second cord blood transplantation (CBT). A 7-year-old boy with relapsed B-precursor acute lymphoblastic leukemia in second remission underwent CBT. However, he received a second CBT due to graft failure. On day 25 after the second CBT, he developed short-term memory defects and seizures. He was diagnosed with HHV-6 encephalitis because HHV-6 DNA was detected in his blood and cerebrospinal fluid and abnormal hippocampal signals were seen on cranial magnetic resonance imaging (MRI). After treatment with foscarnet, HHV-6 DNA levels and MRI findings improved; however, he developed epileptic encephalopathy five months after the onset of encephalitis. There are very few reports on pediatric epileptic encephalopathy associated with HHV-6 encephalitis after HSCT. Detailed studies are needed to analyze risk factors, prognosis, and complications.
Department of Pediatrics, Kyoto University Hospital.
Kagehiro
K
Kouzuki
Itaru
I
Kato
Takeo
T
Kato
Tomoo
T
Daifu
Satoshi
S
Saida
Katsutsugu
K
Umeda
Hidefumi
H
Hiramatsu
Ken-Ichiro
K
Watanabe
Minako
M
Ide
Takeshi
T
Yoshida
Toshihiko
T
Imamura
Kiminari
K
Ito
Toshio
T
Heike
Souichi
S
Adachi
D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D018792:Encephalitis, Viral / Q000150:complications*; D004827:Epilepsy / Q000821:virology*; D015654:Herpesvirus 6, Human / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*