Case Report: Severe Gastrointestinal Inflammation and Persistent HHV-6B Infection in a Paediatric Cancer Patient

Authors: Breddemann, André1; Läer, Stephanie1; Schmidt, Klaus G.2; Harjes, Malte2; Adam, Rüdiger3; Ludwig, Amei4; Niehues, Tim5; Schneider, Dominik T.6

Source: Herpes, Volume 14, Number 2, 2007 , pp. 41-44(4)

Publisher: Cambridge Medical Publications

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Abstract:

Lymphotropic herpesviruses such as human herpesvirus type 6 (HHV-6) have enhanced pathogenicity in some immunocompromised hosts, such as transplant recipients and HIV-infected patients. The clinical relevance of HHV-6 infections in cancer patients undergoing conventional cytotoxic therapy is undetermined, however. Here we report on a 10-month-old boy with an anaplastic astrocytoma, who acquired an HHV-6 variant B infection during chemotherapy. HHV-6B infection caused or triggered severe gastrointestinal inflammation with intractable diarrhoea and failure to thrive over several months. The clinical symptoms were associated with pronounced (CD4) lymphopenia and a marked increase in serum immunoglobulin A levels. After unsuccessful therapy with ganciclovir and foscarnet, combined antiviral and anti-inflammatory treatment with cidofovir and prednisolone controlled the HHV-6 infection and enabled resolution of clinical symptoms.

Keywords: CHILDREN; IMMUNOSUPPRESSION; HHV-6; PHARMACOTHERAPY; GANCICLOVIR; FOSCARNET; CIDOFOVIR

Document Type: Case report

Affiliations: 1: Department of Clinical Pharmacy and Pharmacotherapy, Heinrich-Heine-University of Düsseldorf, Germany 2: Department of Paediatric Cardiology and Pulmonology, Heinrich-Heine-University of Düsseldorf, Germany 3: Department of General Paediatrics, Heinrich-Heine-University of Düsseldorf, Germany 4: Department of Virology, Heinrich-Heine-University of Düsseldorf, Germany 5: Department of Paediatric Oncology, Haematology and Immunology, Heinrich-Heine-University of Düsseldorf, Germany, Heinrich-Heine-University of Düsseldorf, Germany 6: Department of Paediatric Oncology, Haematology and Immunology, Heinrich-Heine-University of Düsseldorf, Germany

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