Hyponatremia associated with human herpesvirus-6 (HHV-6) encephalitis after allogeneic hematopoietic stem cell transplantation: A presentation different from HHV-6 myelitis

Koichi Murakami, Sumiko Kohashi, Masatoshi Sakurai, Jun Kato, Takaaki Toyama, Yuya Koda, Yusuke Yamane, Risa Hashida, Ryohei Abe, Rie Yamazaki, Taku Kikuchi, Takayuki Shimizu, Shigeaki Suzuki, Naoki Hasegawa, Shinichiro Okamoto, Takehiko Mori

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Abstract

Human herpesvirus-6 (HHV-6) encephalitis and myelitis following allogeneic hematopoietic stem cell transplantation (HSCT) is frequently life-threatening. We retrospectively evaluated the clinical significance of hyponatremia in cases of HHV-6 encephalitis/myelitis. Using an institutional database and medical records, we identified and retrospectively analyzed 16 cases of HHV-6 encephalitis and/or myelitis after allogeneic HSCT. HHV-6 encephalitis and myelitis were defined as the symptoms/signs with HHV-6-DNA in the cerebrospinal fluid. Seizure and memory disorder were defined as symptoms/signs of encephalitis, and dysesthesia and vesicorectal disorder as those of myelitis. Five patients developed encephalitis with or without myelitis, and 11 patients developed myelitis alone. Hyponatremia (median 129.1 mEq/L; range 125.9–130.1) was observed in all five patients with HHV-6 encephalitis at diagnosis, and values were significantly lower than those in patients with HHV-6 myelitis alone (median 137.6; range 134.0–142.2; P < 0.01). In three of the five patients with encephalitis, the decrease in sodium level preceded the clinical onset of encephalitis by one or two days. These results suggest that hyponatremia may be an important manifestation of HHV-6 encephalitis, but not of myelitis, and could be a useful tool for the early prediction or diagnosis of HHV-6 encephalitis.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalInternational Journal of Hematology
DOIs
Publication statusAccepted/In press - 2017 May 13

Fingerprint

Myelitis
Human Herpesvirus 6
Hyponatremia
Hematopoietic Stem Cell Transplantation
Encephalitis
Signs and Symptoms
Human Herpesvirus 6 encephalitis
Paresthesia
Memory Disorders
Medical Records
Cerebrospinal Fluid
Epilepsy
Sodium
Databases

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Encephalitis
  • Human herpesvirus-6
  • Hyponatremia
  • Myelitis

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Hyponatremia associated with human herpesvirus-6 (HHV-6) encephalitis after allogeneic hematopoietic stem cell transplantation: A presentation different from HHV-6 myelitis",
abstract = "Human herpesvirus-6 (HHV-6) encephalitis and myelitis following allogeneic hematopoietic stem cell transplantation (HSCT) is frequently life-threatening. We retrospectively evaluated the clinical significance of hyponatremia in cases of HHV-6 encephalitis/myelitis. Using an institutional database and medical records, we identified and retrospectively analyzed 16 cases of HHV-6 encephalitis and/or myelitis after allogeneic HSCT. HHV-6 encephalitis and myelitis were defined as the symptoms/signs with HHV-6-DNA in the cerebrospinal fluid. Seizure and memory disorder were defined as symptoms/signs of encephalitis, and dysesthesia and vesicorectal disorder as those of myelitis. Five patients developed encephalitis with or without myelitis, and 11 patients developed myelitis alone. Hyponatremia (median 129.1 mEq/L; range 125.9–130.1) was observed in all five patients with HHV-6 encephalitis at diagnosis, and values were significantly lower than those in patients with HHV-6 myelitis alone (median 137.6; range 134.0–142.2; P < 0.01). In three of the five patients with encephalitis, the decrease in sodium level preceded the clinical onset of encephalitis by one or two days. These results suggest that hyponatremia may be an important manifestation of HHV-6 encephalitis, but not of myelitis, and could be a useful tool for the early prediction or diagnosis of HHV-6 encephalitis.",
keywords = "Allogeneic hematopoietic stem cell transplantation, Encephalitis, Human herpesvirus-6, Hyponatremia, Myelitis",
author = "Koichi Murakami and Sumiko Kohashi and Masatoshi Sakurai and Jun Kato and Takaaki Toyama and Yuya Koda and Yusuke Yamane and Risa Hashida and Ryohei Abe and Rie Yamazaki and Taku Kikuchi and Takayuki Shimizu and Shigeaki Suzuki and Naoki Hasegawa and Shinichiro Okamoto and Takehiko Mori",
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doi = "10.1007/s12185-017-2254-9",
language = "English",
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T1 - Hyponatremia associated with human herpesvirus-6 (HHV-6) encephalitis after allogeneic hematopoietic stem cell transplantation

T2 - A presentation different from HHV-6 myelitis

AU - Murakami, Koichi

AU - Kohashi, Sumiko

AU - Sakurai, Masatoshi

AU - Kato, Jun

AU - Toyama, Takaaki

AU - Koda, Yuya

AU - Yamane, Yusuke

AU - Hashida, Risa

AU - Abe, Ryohei

AU - Yamazaki, Rie

AU - Kikuchi, Taku

AU - Shimizu, Takayuki

AU - Suzuki, Shigeaki

AU - Hasegawa, Naoki

AU - Okamoto, Shinichiro

AU - Mori, Takehiko

PY - 2017/5/13

Y1 - 2017/5/13

N2 - Human herpesvirus-6 (HHV-6) encephalitis and myelitis following allogeneic hematopoietic stem cell transplantation (HSCT) is frequently life-threatening. We retrospectively evaluated the clinical significance of hyponatremia in cases of HHV-6 encephalitis/myelitis. Using an institutional database and medical records, we identified and retrospectively analyzed 16 cases of HHV-6 encephalitis and/or myelitis after allogeneic HSCT. HHV-6 encephalitis and myelitis were defined as the symptoms/signs with HHV-6-DNA in the cerebrospinal fluid. Seizure and memory disorder were defined as symptoms/signs of encephalitis, and dysesthesia and vesicorectal disorder as those of myelitis. Five patients developed encephalitis with or without myelitis, and 11 patients developed myelitis alone. Hyponatremia (median 129.1 mEq/L; range 125.9–130.1) was observed in all five patients with HHV-6 encephalitis at diagnosis, and values were significantly lower than those in patients with HHV-6 myelitis alone (median 137.6; range 134.0–142.2; P < 0.01). In three of the five patients with encephalitis, the decrease in sodium level preceded the clinical onset of encephalitis by one or two days. These results suggest that hyponatremia may be an important manifestation of HHV-6 encephalitis, but not of myelitis, and could be a useful tool for the early prediction or diagnosis of HHV-6 encephalitis.

AB - Human herpesvirus-6 (HHV-6) encephalitis and myelitis following allogeneic hematopoietic stem cell transplantation (HSCT) is frequently life-threatening. We retrospectively evaluated the clinical significance of hyponatremia in cases of HHV-6 encephalitis/myelitis. Using an institutional database and medical records, we identified and retrospectively analyzed 16 cases of HHV-6 encephalitis and/or myelitis after allogeneic HSCT. HHV-6 encephalitis and myelitis were defined as the symptoms/signs with HHV-6-DNA in the cerebrospinal fluid. Seizure and memory disorder were defined as symptoms/signs of encephalitis, and dysesthesia and vesicorectal disorder as those of myelitis. Five patients developed encephalitis with or without myelitis, and 11 patients developed myelitis alone. Hyponatremia (median 129.1 mEq/L; range 125.9–130.1) was observed in all five patients with HHV-6 encephalitis at diagnosis, and values were significantly lower than those in patients with HHV-6 myelitis alone (median 137.6; range 134.0–142.2; P < 0.01). In three of the five patients with encephalitis, the decrease in sodium level preceded the clinical onset of encephalitis by one or two days. These results suggest that hyponatremia may be an important manifestation of HHV-6 encephalitis, but not of myelitis, and could be a useful tool for the early prediction or diagnosis of HHV-6 encephalitis.

KW - Allogeneic hematopoietic stem cell transplantation

KW - Encephalitis

KW - Human herpesvirus-6

KW - Hyponatremia

KW - Myelitis

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JO - International Journal of Hematology

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