Abstract
Severe abdominal pain followed by inappropriate antidiuretic hormone secretion (SIADH) preceding by several days the skin manifestation of varicella-zoster virus (VZV) infection in an immunocompromised patient is described. This is a rare presentation of a severe infection described previously only once in a chronic myeloid leukemia (CML) patient 5 months post allo-BMT during immunosuppressive treatment with cyclosporin A. This is the first case described in the setting of non-myeloablative preparation with fludarabine and melphalan and followed by donor leukocyte infusion (DLI) 2 and 4 months post allo-BMT. The influence of these factors on development of VZV virus infection is discussed. We also highlight the high incidence and high mortality in VZV infection in immunocompromised patients as well as the frequent atypical presentation. Bone Marrow Transplantation (2000) 26, 231–233.
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References
Kok T, Mickan L, Schepetiuk S . Rapid detection, culture-amplification and typing of herpes simplex virus by immunoassay in clinical samples Clin Diagn Virol 1998 10: 67–74
Drakos P, Weinberg M, Delukina M et al. Inappropriate antidiuretic hormone secretion (SIADH) preceding skin manifestations of disseminated varicella zoster virus infection Bone Marrow Transplant 1993 11: 407–408
Consoli U, El-Tounsi I, Sandoval A et al. Differential induction of apoptosis by fludarabine monophosphate in leukemic B and normal T cells in chronic lymphocytic leukemia Blood 1998 91: 1742–1748
Bahceci E, Epperson D, Patibandla A et al. Rapid reconstitution of T-cell department after non-myeloablative allogeneic stem cell transplantation. ASH, Dec 3–7, 1999 Blood 1999 94: (Suppl.1) Abstr. 590
Rowland P, Wald ER, Mirro JR Jr et al. Progressive varicella presenting with pain and minimal skin involvement in children with acute lymphoblastic leukemia J Clin Oncol 1995 13: 1697–1703
Lum LG . The kinetics of immune reconstitution after human marrow transplantation Blood 1987 69: 369–380
Guillaume T, Rubinstein DB, Symann M . Immune reconstitution and immunotherapy after autologous haematopoietic stem cell transplantation Blood 1998 92: 1471–1490
Wacker P, Hartmann O, Benhamou E et al. Varicella-zoster virus infections after autologous bone marrow transplantation in children Bone Marrow Transplant 1989 4: 191–194
Bilgrami S, Chakraborty NG, Rodriguez-Pinero F et al. Varicella zoster virus infection associated with high-dose chemotherapy and autologous stem-cell rescue Bone Marrow Transplant 1999 23: 469–474
Locksley RM, Flournoy N, Sullivan KM et al. Infection with varicella-zoster virus after marrow transplantation J Infect Dis 1985 152: 1172–1181
Ljungman P, Wilczek H, Gahrton G et al. Long-term acyclovir prophylaxis in bone marrow transplant recipients and lymphocyte proliferation responses to herpes virus antigens in vitro Bone Marrow Transplant 1986 1: 185–192
Cohen JI, Brunell PA, Straus SE et al. Recent advances in varicella-zoster infection Ann Intern Med 1999 130: 922–932
Shepp DH, Dandliker PS, Meyers JD . Treatment of varicella-zoster virus infection in severely immunocompromised patients New Engl J Med 1986 314: 208–212
Balfour HH, McMonigal KA, Beam B . Acyclovir therapy of varicella-zoster virus infections in immunocompromised patients J Antimicrobial Chemother 1983 12: (Suppl. B) 169–179
David DS, Tegtmeier BR, O'Donelli MR et al. Visceral varicella-zoster after bone marrow transplantation: report of a case and review of the literature Am J Gastroenterol 1998 93: 810–813
Moses AM, Streeten DH . Disorders of the neurohypophysis. Syndromes associated with vasopressin excess. In: Isselbacher KY, Braunwald E, Wilson JD et al Harrison's Principles of Internal Medicine, 13th edn, Vol. 2 McGraw-Hill, USA 1994 pp1928–1930
Ingraham IE, Estes MA, Bern MM et al. Disseminated varicella-zoster virus infection with the syndrome of inappropriate antidiuretic hormone Arch Intern Med 1983 143: 1270–1271
Arvin AM . Varicella-zoster virus infections. In: Thomas ED, Blume KG, Forman SJ (eds) Hematopoietic Cell Transplantation, 2nd edn Blackwell Science: USA 1999 591–606
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Szabó, F., Horvath, N., Seimon, S. et al. Inappropriate antidiuretic hormone secretion, abdominal pain and disseminated varicella-zoster virus infection: an unusual triad in a patient 6 months post mini-allogeneic peripheral stem cell transplant for chronic myeloid leukemia. Bone Marrow Transplant 26, 231–233 (2000). https://doi.org/10.1038/sj.bmt.1702486
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DOI: https://doi.org/10.1038/sj.bmt.1702486
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