Prolonged Sinus Tachycardia Caused by Human Herpesvirus 6 (HHV6) Encephalomyelitis after Allogeneic Bone Marrow Transplantation

Mitsutaka Nishimoto; Hirohisa Nakamae; Yoshiki Hayashi; Hideo Koh; Takahiko Nakane; Masahiro Yoshida; Masato Bingo; Hiroshi Okamura; Mizuki Aimoto; Satoru Nanno; Takuro Yoshimura; Akiko Inaba; Kiyoyuki Hagihara; Mika Nakamae; Asao Hirose; Yoshitaka Nakao; Yoshiki Terada; Masayuki Hino

doi:10.2169/internalmedicine.51.6640

CASE REPORTS

Prolonged Sinus Tachycardia Caused by Human Herpesvirus 6 (HHV6) Encephalomyelitis after Allogeneic Bone Marrow Transplantation

Mitsutaka Nishimoto, Hirohisa Nakamae, Yoshiki Hayashi, Hideo Koh, Takahiko Nakane, Masahiro Yoshida, Masato Bingo, Hiroshi Okamura, Mizuki Aimoto, Satoru Nanno, Takuro Yoshimura, Akiko Inaba, Kiyoyuki Hagihara, Mika Nakamae, Asao Hirose, Yoshitaka Nakao, Yoshiki Terada, Masayuki Hino

Author information

Mitsutaka Nishimoto
Hematology, Graduate School of Medicine, Osaka City University, Japan
Hirohisa Nakamae
Hematology, Graduate School of Medicine, Osaka City University, Japan
Yoshiki Hayashi
Hematology, Graduate School of Medicine, Osaka City University, Japan
Hideo Koh
Hematology, Graduate School of Medicine, Osaka City University, Japan
Takahiko Nakane
Hematology, Graduate School of Medicine, Osaka City University, Japan
Masahiro Yoshida
Hematology, Graduate School of Medicine, Osaka City University, Japan
Masato Bingo
Hematology, Graduate School of Medicine, Osaka City University, Japan
Hiroshi Okamura
Hematology, Graduate School of Medicine, Osaka City University, Japan
Mizuki Aimoto
Hematology, Graduate School of Medicine, Osaka City University, Japan
Satoru Nanno
Hematology, Graduate School of Medicine, Osaka City University, Japan
Takuro Yoshimura
Hematology, Graduate School of Medicine, Osaka City University, Japan
Akiko Inaba
Hematology, Graduate School of Medicine, Osaka City University, Japan
Kiyoyuki Hagihara
Hematology, Graduate School of Medicine, Osaka City University, Japan
Mika Nakamae
Hematology, Graduate School of Medicine, Osaka City University, Japan
Asao Hirose
Hematology, Graduate School of Medicine, Osaka City University, Japan
Yoshitaka Nakao
Hematology, Graduate School of Medicine, Osaka City University, Japan
Yoshiki Terada
Hematology, Graduate School of Medicine, Osaka City University, Japan
Masayuki Hino
Hematology, Graduate School of Medicine, Osaka City University, Japan

Keywords: human herpesvirus 6 (HHV6), encephalomyelitis, dysautonomia, sinus tachycardia

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 10 Pages 1265-1267

DOI https://doi.org/10.2169/internalmedicine.51.6640

Details

Abstract

A 19-year-old man with Philadelphia chromosome-positive acute lymphoblastic leukemia received an allogeneic hematopoietic cell transplant with unrelated bone marrow. On day 20, the patient developed impaired consciousness and disorientation. Examination of the cerebrospinal fluid showed 2×10⁴ copies/mL of HHV6B. HHV6 encephalitis was diagnosed, as had HHV6 myelitis based on symptoms that included lancinating pain/pruritus in the lower limbs and dysuria/dyschezia. Concurrently, he showed sinus tachycardia. Even after clearance of the HHV6 genome from the plasma and CSF was achieved by treatment with foscarnet, sinus tachycardia persisted for another 100 days. We suspected prolonged sinus tachycardia due to dysautonomia caused by HHV6 encephalomyelitis.

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