Case Report: Human herpesvirus 6 reactivation associated with colitis in a lung transplant recipient

Lamoth, Frédéric; Jayet, Pierre‐Yves; Aubert, John‐David; Rotman, Samuel; Mottet, Christian; Sahli, Roland; Lautenschlager, Irmeli; Pascual, Manuel; Meylan, Pascal

doi:10.1002/jmv.21268

Cited by 22 publications

(15 citation statements)

References 18 publications

(23 reference statements)

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“…Likely, the main causes for upper gastrointestinal symptoms were H. pylori induced gastritis, gastro‐oesophageal reflux etc. Although there have been a few case reports describing HHV‐6 colitis [10–12], a recent study on HHV‐6 in over a thousand samples has demonstrated several cases with gastrointestinal biopsies infected with HHV‐6, mostly HHV‐6B and having significant clinical symptoms such diarrhoea, fever and colitis [31]. The experience of antiviral treatment of HHV‐6 infections is very limited and mostly based on the treatment of encephalitis [7].…”

Section: Discussionmentioning

confidence: 99%

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HHV-6B is frequently found in the gastrointestinal tract in kidney transplantation patients

Lempinen

Halme

Arola

et al. 2012

Transplant International

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Summary In immunosuppressed patients human herpesvirus 6 (HHV‐6) reactivations are common. The aim of the study was to determine to which extent HHV‐6 can be found in the gastrointestinal tract in kidney transplant recipients and in patients on chronic dialysis. The HHV‐6 and cytomegalovirus (CMV) examinations were performed on gastro duodenal and colon biopsy specimens obtained from 81 kidney transplant recipients and on 46 chronic dialysis patients. The HHV‐6 and CMV were demonstrated by immunohistochemistry detecting both HHV‐6A and HHV‐6B, and CMV‐specific antigens. The HHV‐6B‐positive cells, were found in gastroduodenal biopsy specimens from 34% of the transplant recipients and 28% of the patients on chronic dialysis, CMV‐positive cells were found in specimens from 53% of the transplant recipients and 28% of the patients on chronic dialysis. The HHV‐6B positive cells were found in the colonic mucosa specimens from 36% of the transplant recipients and 22% of the patients on chronic dialysis, CMV‐positive cells were found in specimens from 36% of the transplant recipients and 17% of the patients on chronic dialysis. The HHV‐6B positive cells were found equally often in the gastroduodenal as in the colorectal mucosa. The HHV‐6B positive cells as well as CMV positive cells were simultaneously found in every fifth of transplant recipients.

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Section: Discussionmentioning

confidence: 99%

“…In stem cell transplant patients with gastrointestinal symptoms, HHV‐6 DNA has been detected by PCR in gastroduodenal and colorectal mucosa [8] and by in situ hybridization in large bowel mucosa [9]. Occasional case reports have described HHV‐6 associated colitis in lung and renal transplant recipients [10–12].…”

Section: Introductionmentioning

confidence: 99%

HHV-6B is frequently found in the gastrointestinal tract in kidney transplantation patients

Lempinen

Halme

Arola

et al. 2012

Transplant International

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“…HHV‐6B reactivation often occurs in immunocompetent individuals during drug induced hypersensitivity syndrome (DIHS) and the related drug rash with eosinophilia and systemic symptoms (DRESS). Symptoms and conditions that have been firmly associated with HHV‐6B in immunocompromised patients include exanthematous rash, fever, seizures , encephalopathy , limbic encephalitis and amnesia , cognitive dysfunction , lymphadenopathy , colitis , and hepatitis . Less well established, and in some cases controversial associations have been reported for Stevens–Johnson syndrome (SJS) , renal failure , hemophagocytic syndrome , myocarditis , pneumonitis , hypogammaglobulinemia , and arteriopathies .…”

Section: Introductionmentioning

confidence: 99%

Chromosomally integrated human herpesvirus 6: questions and answers

Pellett

Ablashi

Ambros

et al. 2011

Reviews in Medical Virology

332

333

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SUMMARYChromosomally integrated human herpesvirus 6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germ line genome and is vertically transmitted in a Mendelian manner. The condition is found in less than 1% of controls in the USA and UK, but has been found at a somewhat higher prevalence in transplant recipients and other patient populations in several small studies. HHV-6 levels in whole blood that exceed 5.5 log10 copies/ml are strongly suggestive of ciHHV-6. Monitoring DNA load in plasma and serum is unreliable, both for identifying and for monitoring subjects with ciHHV-6 due to cell lysis and release of cellular DNA. High HHV-6 DNA loads associated with ciHHV-6 can lead to erroneous diagnosis of active infection. Transplant recipients with ciHHV-6 may be at increased risk for bacterial infection and graft rejection. ciHHV-6 can be induced to a state of active viral replication in vitro. It is not known whether ciHHV-6 individuals are put at clinical risk by the use of drugs that have been associated with HHV-6 reactivation in vivo or in vitro. Nonetheless, we urge careful observation when use of such drugs is indicated in individuals known to have ciHHV-6. Little is known about whether individuals with ciHHV-6 develop immune tolerance for viral proteins. Further research is needed to determine the role of ciHHV-6 in disease. Copyright © 2011 John Wiley & Sons, Ltd.

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“…Active infection by HHV‐6 and HHV‐7 in solid organ transplant recipients is usually asymptomatic. Overt clinical disease directly due to HHV‐6 is estimated to occur in less than 1% of solid organ transplant recipients , reportedly causing fever and rash , hepatitis , gastroduodenitis , colitis , pneumonitis , and encephalitis . It may also present as a CMV‐like syndrome, with fever and some degree of bone marrow suppression .…”

Section: Human Herpesviruses 6 Andmentioning

confidence: 99%

Human Herpesvirus 6, 7 and 8 in Solid Organ Transplantation

Gantt

2013

American Journal of Transplantation

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Case Report: Human herpesvirus 6 reactivation associated with colitis in a lung transplant recipient

Cited by 22 publications

References 18 publications

HHV-6B is frequently found in the gastrointestinal tract in kidney transplantation patients

HHV-6B is frequently found in the gastrointestinal tract in kidney transplantation patients

Chromosomally integrated human herpesvirus 6: questions and answers

Human Herpesvirus 6, 7 and 8 in Solid Organ Transplantation

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