title: Pericarditis Associated With Human Herpesvirus-6 Reactivation in a Patient After Unrelated Cord Blood Transplant.
abstract: A 53-year-old woman with myelodysplastic syndrome received a cord blood transplant because she had frequent episodes of febrile neutropenia. As a conditioning regimen for transplant, she received 12 Gy total body irradiation, intravenous cytosine arabinoside 3 g/m2 every 12 hours on days -5 and -4, and cyclophosphamide 60 mg/kg/day on days -3 and -2. She received tacrolimus and short-term methotrexate treatment as prophylaxis for graft-versus-host disease. Her cardiac function was normal before transplant. She developed acute heart failure with a mild pericardial effusion 11 days after transplant, but her failure improved with a diuretic, vasodilator, and inotropic agent. She complained of dyspnea, and chest auscultation revealed pericardial friction rubs on day 28. Massive pericardial effusion was detected by echocardiography and pericarditis was diagnosed. The pericardial space was drained by pericardiocentesis. The pericardial fluid was exudative, but no bacteria or fungi were cultured. On viral polymerase chain reaction examination, human herpesvirus-6 was detected at a level of 3 × 104 copies/mL in the pericardial effusion, but not in the peripheral blood. With conservative treatment alone, that did not include antiviral therapy, her symptoms disappeared on day 56. We conclude that human herpesvirus-6 reactivation may have been associated with her pericarditis.
authors.affiliation: From the Department of Hematology, Osaka City General Hospital, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Nakamae
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okamura
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Nishimoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hideo
authors.initials: H
authors.lastname: Koh
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakane
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000601:surgery*; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000628:therapy / Q000821:virology; D020519:Pericardiocentesis; D010493:Pericarditis / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014775:Virus Activation
chemical_list: D002317:Cardiovascular Agents; D004279:DNA, Viral; D007166:Immunosuppressive Agents