Human Herpes Virus 6 Encephalitis Following Bone Marrow Transplantation with Uncommon Magnetic Resonance Imaging Findings.
10.12779/dnd.2016.15.3.88
- Author:
Jihye HWANG
1
;
Ji Eun KIM
;
Jee Hoon ROH
;
Jae Hong LEE
Author Information
1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhlee@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
herpes;
human herpes virus;
Human Herpes Virus 6 encephalitis;
limbic encephalitis;
retrograde amnesia;
anterograde amnesia
- MeSH:
Adult;
Amnesia, Anterograde;
Amnesia, Retrograde;
Atrophy;
Bone Marrow Transplantation*;
Bone Marrow*;
Brain;
Cerebrospinal Fluid;
DNA;
DNA, Viral;
Encephalitis*;
Female;
Fever;
Ganciclovir;
Herpesvirus 6, Human;
Humans*;
Limbic Encephalitis;
Magnetic Resonance Imaging*;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Siblings;
Temporal Lobe
- From:Dementia and Neurocognitive Disorders
2016;15(3):88-91
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Human Herpes Virus 6 (HHV6) is commonly associated with encephalitis following bone marrow transplantation. However, hippocampal atrophy and global hypometabolism are rare findings in HHV6 encephalitis. CASE REPORT: A 41-year-old right-handed woman with acute lymphoblastic leukemia presented with fever and mental changes 2 weeks after receiving a sibling bone marrow transplant. The patient's cerebrospinal fluid (CSF) was positive for HHV-6 deoxyribonucleic acid (DNA), but was negative for other viral DNA. Brain magnetic resonance imaging revealed atrophic changes in bilateral medial temporal lobes. Following 4 weeks of ganciclovir therapy, a CSF exam was negative for HHV-6 DNA and the patient's neurological symptoms partially improved. However, she was disoriented and had severe retrograde and anterograde amnesia. 18F-fluorodeoxyglucose-positron emission tomography indicated global hypometabolism in the medial temporal lobes and the fronto-parietal cortices. CONCLUSIONS: This is a rare and unusual case of hippocampal atrophy in the acute stage of HHV6 encephalitis. Our imaging findings may reflect the chronic indolent course of HHV6 encephalitis.
