PMID- 9177444
OWN - NLM
STAT- MEDLINE
DCOM- 19970702
LR  - 20190914
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 11
IP  - 6
DP  - 1997 Jun
TI  - Angioimmunoblastic lymphadenopathy with disseminated human herpesvirus 6 
      infection in a patient with acute myeloblastic leukemia.
PG  - 882-5
AB  - A 47-year-old man with acute myeloblastic leukemia (AML) developed 
      angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) 4 months after 
      induction chemotherapy for AML. During a leukopenic period, the patient suffered 
      from pericarditis with massive pericardial effusion in which human herpesvirus 6 
      (HHV-6) DNA was detected. Although complete remission of AML was achieved, fever 
      persisted and atypical skin rash followed by generalized lymphadenopathy along 
      with polyclonal hypergammaglobulinemia appeared. A diagnosis of AILD was made on 
      a biopsy specimen of the inguinal lymph node. The patient died of fulminant 
      hepatitis and the autopsy showed lymphomatous infiltrates involving the liver, 
      bone marrow, lungs, spleen, kidneys and heart. HHV-6 DNA sequences were 
      identified in the biopsy specimen of the lymph node and in the involved organ 
      tissues. HHV-6 in this patient was variant B. It is known that HHV-6 can be 
      reactivated in immunocompromised patients and causes severe complications. This 
      unusual clinical course suggests that the immunosuppression associated with AML 
      and the additional iatrogenic immunosuppression following cytopenia-inducing 
      chemotherapy predisposed the patient to reactivated HHV-6 infection. The 
      sequential detection of this virus before and after manifestation of AILD may 
      support the evidence that HHV-6 infection could directly or indirectly trigger 
      AILD. This is the first time that such a sequence of events has been reported to 
      our knowledge. The possibility of HHV-6 infection should be considered when 
      unexplained fever and generalized lymphadenopathy are seen in patients with 
      leukemia, and administration of antiviral agents should be considered for the 
      diagnostic evaluation.
FAU - Daibata, M
AU  - Daibata M
AD  - Department of Medicine, Kochi Medical School, Japan.
FAU - Ido, E
AU  - Ido E
FAU - Murakami, K
AU  - Murakami K
FAU - Kuzume, T
AU  - Kuzume T
FAU - Kubonishi, I
AU  - Kubonishi I
FAU - Taguchi, H
AU  - Taguchi H
FAU - Miyoshi, I
AU  - Miyoshi I
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (DNA, Viral)
RN  - 04079A1RDZ (Cytarabine)
RN  - ZRP63D75JW (Idarubicin)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Autopsy
MH  - Cytarabine/administration & dosage
MH  - DNA, Viral/analysis
MH  - Fatal Outcome
MH  - Fever
MH  - Herpesviridae Infections/*complications/pathology
MH  - *Herpesvirus 6, Human/isolation & purification
MH  - Humans
MH  - Hypergammaglobulinemia/complications
MH  - Idarubicin/administration & dosage
MH  - Immunoblastic Lymphadenopathy/*complications/immunology/pathology
MH  - Immunophenotyping
MH  - Leukemia, Myeloid, Acute/*drug therapy
MH  - Lymph Nodes/pathology/virology
MH  - Male
MH  - Middle Aged
MH  - Pericarditis/complications
MH  - Polymerase Chain Reaction/methods
MH  - Remission Induction
MH  - Tumor Virus Infections/*complications/pathology
EDAT- 1997/06/01 00:00
MHDA- 1997/06/01 00:01
CRDT- 1997/06/01 00:00
PHST- 1997/06/01 00:00 [pubmed]
PHST- 1997/06/01 00:01 [medline]
PHST- 1997/06/01 00:00 [entrez]
AID - 10.1038/sj.leu.2400671 [doi]
PST - ppublish
SO  - Leukemia. 1997 Jun;11(6):882-5. doi: 10.1038/sj.leu.2400671.