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Posterior reversible encephalopathy syndrome in a child with post-transplant HHV-6B encephalitis

Bone Marrow Transplantation volume 47, pages 1381–1382 (2012)Cite this article

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Human herpesvirus 6B (HHV-6B) is the etiologic agent of exanthem subitum, a common febrile illness in infants and young children.1 Like other human herpesviruses, the virus remains latent in hosts after primary HHV-6B infection and reactivates in immunocompromised patients, including hematopoietic stem cell transplant (HSCT) recipients. On the basis of in vitro and in vivo investigations, HHV-6B is thought to have neurovirulence.2, 3 Our recent data suggested that the pathogenesis and clinical features of HHV-6B encephalitis are different in patients with primary infection and HSCT recipients with viral reactivation.4 Various types of clinical manifestations including acute encephalopathy with biphasic seizures and late reduced diffusion, acute necrotizing encephalopathy and hemorragic shock and encephalopathy syndrome have been reported in patients with primary HHV-6B encephalitis.5 It is also well known that HHV-6B is the most important pathogen in post-transplant acute limbic encephalitis.6

Posterior reversible encephalopathy syndrome (PRES) was first reported by Hinchey et al.7 as a syndrome of headaches, confusion, seizures and visual disturbances associated with transient, predominantly posterior white matter changes on neuroimaging studies. PRES has been associated with a number of medical conditions, including hypertensive encephalopathy, eclampsia, and the use of cytotoxic and immunosuppressive drugs. PRES is also seen in solid organ transplant recipients and HSCT recipients. Although several infectious agents are thought to be involved in its pathophysiology,8 no cases of PRES associated with HHV-6B have been reported to date. Herein, we report the first case of PRES with HHV-6B reactivation after HSCT.

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Authors and Affiliations

  1. Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan

    Y Kawamura, M Ohashi & T Yoshikawa

  2. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    H Asahito, Y Takahashi & S Kojima

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  1. Y Kawamura
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  2. M Ohashi
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  3. H Asahito
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  6. T Yoshikawa
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Correspondence to T Yoshikawa.

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Kawamura, Y., Ohashi, M., Asahito, H. et al. Posterior reversible encephalopathy syndrome in a child with post-transplant HHV-6B encephalitis. Bone Marrow Transplant 47, 1381–1382 (2012). https://doi.org/10.1038/bmt.2012.42

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