Alexandre Mestre Tejo , Jacqueline Alves Rena , Camila Malta Romano , Amanda Lopes da Silva , Maria Cássia Mendes-Correa , Tânia Regina Tozetto Mendoza , Hermes Ryoiti Higashino , Bruno Garcia Pires , Vanderson Rocha , Silvia Figueiredo Costa
{"title":"Coinfection of HHV 6 and HTLV-I Causing Encephalitis After Autologous Hematopoietic Stem Cell Transplantation: A Case Report and a Systematic Review of the Literature","authors":"Alexandre Mestre Tejo , Jacqueline Alves Rena , Camila Malta Romano , Amanda Lopes da Silva , Maria Cássia Mendes-Correa , Tânia Regina Tozetto Mendoza , Hermes Ryoiti Higashino , Bruno Garcia Pires , Vanderson Rocha , Silvia Figueiredo Costa","doi":"10.1016/j.transproceed.2025.02.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>A 52-year-old woman with multiple myeloma and asymptomatic human T lymphotropic virus (HTLV)-I infection underwent an autologous stem cell transplantation. Eighteen days after transplantation, she developed fever, headache, ataxia, and tremors. Coinfection of human herpesvirus 6 and HTLV-I encephalitis was diagnosed.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was made. No article about HTLV I/II encephalitis in autologous stem cell transplantation was found. A total of 268 articles were screened and 8 matched the inclusion criteria. One was included by another source. Three of the 9 articles analyzed were excluded and 6 cases of human herpesvirus 6 encephalitis after ASCT were analyzed.</div></div><div><h3>Results</h3><div>The median patient age was 51 years. Multiple myeloma was the most common hematologic disease found. The median time since the hematopoietic stem cells transplantation was 19.5 days. Melphalan-based conditioning therapy was present in 83% of patients. All cerebrospinal fluid presented altered cell count and proteinorachia (median, 68.5 mg/dL). Most patients were treated with ganciclovir or foscarnet. In all cases, patients experienced a complete recovery.</div></div><div><h3>Conclusion</h3><div>HTLV-I encephalitis is an extremely rare disease that should be considered in patients previously infected. Human herpesvirus 6 encephalitis in patients after autologous hematopoietic stem cells transplantation is an uncommon situation but should be remembered in the differential in cases of acute confusional state. Prompt treatment may ensure complete recovery of the patient.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 508-513"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0041134525001009","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Coinfection of HHV 6 and HTLV-I Causing Encephalitis After Autologous Hematopoietic Stem Cell Transplantation: A Case Report and a Systematic Review of the Literature
Background
A 52-year-old woman with multiple myeloma and asymptomatic human T lymphotropic virus (HTLV)-I infection underwent an autologous stem cell transplantation. Eighteen days after transplantation, she developed fever, headache, ataxia, and tremors. Coinfection of human herpesvirus 6 and HTLV-I encephalitis was diagnosed.
Methods
A systematic review of the literature was made. No article about HTLV I/II encephalitis in autologous stem cell transplantation was found. A total of 268 articles were screened and 8 matched the inclusion criteria. One was included by another source. Three of the 9 articles analyzed were excluded and 6 cases of human herpesvirus 6 encephalitis after ASCT were analyzed.
Results
The median patient age was 51 years. Multiple myeloma was the most common hematologic disease found. The median time since the hematopoietic stem cells transplantation was 19.5 days. Melphalan-based conditioning therapy was present in 83% of patients. All cerebrospinal fluid presented altered cell count and proteinorachia (median, 68.5 mg/dL). Most patients were treated with ganciclovir or foscarnet. In all cases, patients experienced a complete recovery.
Conclusion
HTLV-I encephalitis is an extremely rare disease that should be considered in patients previously infected. Human herpesvirus 6 encephalitis in patients after autologous hematopoietic stem cells transplantation is an uncommon situation but should be remembered in the differential in cases of acute confusional state. Prompt treatment may ensure complete recovery of the patient.
期刊介绍：
Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication.
The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics.
Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board.
Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.
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