A young woman on rituximab and two other immunomodulatory agents for the treatment of dermatomyositis developed encephalitis with severe anterograde amnesia. As the use of biologic treatments for refractory autoimmune disease has been increasing, physicians are advised to consider HHV-6 and offer prompt antiviral therapy to limit irreversible morbidity.
Latvian researchers studied autopsy material from the olfactory bulb in patients with HHV-6 encephalopathy vs. controls and reported surprising differences.
A new point-of-care assay from bioMérieux can simultaneously and rapidly detect 14 pathogens typically found in encephalitis. The machine is designed to be at the clinic or in the emergency room and can be operated by unskilled technicians. In a study of 1,560 immunocompetent patient samples, a total of 1.35% were positive for HHV-6, or about twice the expected rate of 0.8% found with the inherited chromosomally integrated HHV-6.
A fifth case of limbic encephalitis associated with GAD antibodies and HHV-6 infection has been reported, this time in an immunocompetent woman with chromosomally integrated HHV-6, epilepsy, and psychosis. The patient’s condition improved (with a drop in GAD antibody titers and stabilization of psychotic symptoms) in response to three weeks of antiviral therapy but relapsed when antiviral therapy was withdrawn.
Autopsy brain samples from 51 controls and 57 patients who died with encephalopathy of unknown origin were tested for HHV-6 & HHV-7 using immunohistochemistry, nested and real time PCR.
A prospective study authored by Joshua Hill and Danielle Zerr determined that higher than average HHV-6B DNA levels increased the odds of developing delirium after cord blood transplantation (CBT) by almost three fold. Patients with DNA loads in the top quartile had a 4.5 fold increase in delirium.
Two new reviews conclude that HHV-6 acute necrotizing encephalopathy is tied to a mutation of the RANBP2 gene.
Tehran University of Medical Sciences reports HHV-6 DNA in cerebrospinal fluid (CSF) samples of 8.8% of 114 infants suspected of encephalitis.
Experts emphasize need for larger studies to determine the impact of ciHHV-6 on patient outcomes
Edaravone shows promise for reducing oxidation and neuronal damage in AESD.
Should physicians automatically discount HHV-6 if any other pathogen is found in the CSF? Should patients with both HHV-6 and EBV DNA in the CSF be treated only for EBV? These are the questions that UW group tried to sort out in this study.
A group from Japan has conducted a retrospective study of 130 patients who underwent stem cell transplantation in an attempt to identify a risk factor for the development of encephalopathy.
HHV-6 encephalitis as a trigger in children with POLG mitochondrial disorders? Two cases of fatal Alpers-Huttenlocher syndrome
Japanese group identifies several cytokine and chemokine responses associated with HHV-6B encephalopathy.
Case report describes child with multiple episodes of febrile status epilepticus, followed by chorea and developmental regression, caused by human herpes virus-6 encephalitis.
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