Life-threatening human herpes virus-6 infection in early childhood: presenting symptom of a primary immunodeficiency?

M.P. Hennus; J.M. van Montfrans; A.J. van Vught; K. Tesselaar; J.J. Boelens; N.J.G. Jansen

doi:10.1097/PCC.0b013e31819bb956

Life-threatening human herpes virus-6 infection in early childhood: presenting symptom of a primary immunodeficiency?

M.P. Hennus, J.M. van Montfrans, A.J. van Vught, K. Tesselaar, J.J. Boelens, N.J.G. Jansen

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To report two previously healthy children with a life-threatening course of human herpes virus type 6 (HHV-6) infection and prolonged pediatric intensive care treatment.

DESIGN: Case reports.

SETTING: A 16 bed pediatric intensive care unit at a tertiary care children's hospital.

PATIENTS: Two children with life-threatening HHV-6 disease.

INTERVENTIONS: Both children were mechanically ventilated because of respiratory failure. A detailed viral and immunologic workup was performed and treatment with antiviral medication started.

MEASUREMENTS: Polymerase chain reaction assays of plasma, cerebrospinal fluid, bronchoalveolar lavage, and lung biopsies yielded HHV-6 in both patients. Immunophenotyping and lymphocyte stimulation tests with both mitogens and antigens indicated an immunodeficiency in both patients.

CONCLUSION: HHV-6 infection should be considered in infants and young children with respiratory failure or meningo-encephalitis without clear causative agent or failure to respond to empirical treatment. A thorough immunologic workup and early start with antiviral therapy in any patient with a life-threatening course of HHV-6 infection is mandatory, because a severe HHV-6 infection can be the first indication of a primary immunodeficiency.

Original language	English
Pages (from-to)	e16-e18
Journal	Pediatric Critical Care Medicine
Volume	10
Issue number	2
DOIs	https://doi.org/10.1097/PCC.0b013e31819bb956
Publication status	Published - 2009

Keywords

Bronchoalveolar Lavage Fluid
Child, Preschool
DNA, Viral
Female
Herpesvirus 6, Human
Humans
Immunologic Deficiency Syndromes
Intensive Care Units, Pediatric
Male
Polymerase Chain Reaction
Roseolovirus Infections
Severity of Illness Index

Access to Document

10.1097/PCC.0b013e31819bb956

http://www.ncbi.nlm.nih.gov/pubmed/19265361

Embargoed Document

KT Pediatr Crit Car Med March 2009
Final published version, 680 KB
Embargo ends: 1/01/50

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title = "Life-threatening human herpes virus-6 infection in early childhood: presenting symptom of a primary immunodeficiency?",

abstract = "OBJECTIVE: To report two previously healthy children with a life-threatening course of human herpes virus type 6 (HHV-6) infection and prolonged pediatric intensive care treatment.DESIGN: Case reports.SETTING: A 16 bed pediatric intensive care unit at a tertiary care children's hospital.PATIENTS: Two children with life-threatening HHV-6 disease.INTERVENTIONS: Both children were mechanically ventilated because of respiratory failure. A detailed viral and immunologic workup was performed and treatment with antiviral medication started.MEASUREMENTS: Polymerase chain reaction assays of plasma, cerebrospinal fluid, bronchoalveolar lavage, and lung biopsies yielded HHV-6 in both patients. Immunophenotyping and lymphocyte stimulation tests with both mitogens and antigens indicated an immunodeficiency in both patients.CONCLUSION: HHV-6 infection should be considered in infants and young children with respiratory failure or meningo-encephalitis without clear causative agent or failure to respond to empirical treatment. A thorough immunologic workup and early start with antiviral therapy in any patient with a life-threatening course of HHV-6 infection is mandatory, because a severe HHV-6 infection can be the first indication of a primary immunodeficiency.",

keywords = "Bronchoalveolar Lavage Fluid, Child, Preschool, DNA, Viral, Female, Herpesvirus 6, Human, Humans, Immunologic Deficiency Syndromes, Intensive Care Units, Pediatric, Male, Polymerase Chain Reaction, Roseolovirus Infections, Severity of Illness Index",

author = "M.P. Hennus and {van Montfrans}, J.M. and {van Vught}, A.J. and K. Tesselaar and J.J. Boelens and N.J.G. Jansen",

year = "2009",

doi = "10.1097/PCC.0b013e31819bb956",

language = "English",

volume = "10",

pages = "e16--e18",

journal = "Pediatric Critical Care Medicine",

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T1 - Life-threatening human herpes virus-6 infection in early childhood

T2 - presenting symptom of a primary immunodeficiency?

AU - Hennus, M.P.

AU - van Montfrans, J.M.

AU - van Vught, A.J.

AU - Tesselaar, K.

AU - Boelens, J.J.

AU - Jansen, N.J.G.

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: To report two previously healthy children with a life-threatening course of human herpes virus type 6 (HHV-6) infection and prolonged pediatric intensive care treatment.DESIGN: Case reports.SETTING: A 16 bed pediatric intensive care unit at a tertiary care children's hospital.PATIENTS: Two children with life-threatening HHV-6 disease.INTERVENTIONS: Both children were mechanically ventilated because of respiratory failure. A detailed viral and immunologic workup was performed and treatment with antiviral medication started.MEASUREMENTS: Polymerase chain reaction assays of plasma, cerebrospinal fluid, bronchoalveolar lavage, and lung biopsies yielded HHV-6 in both patients. Immunophenotyping and lymphocyte stimulation tests with both mitogens and antigens indicated an immunodeficiency in both patients.CONCLUSION: HHV-6 infection should be considered in infants and young children with respiratory failure or meningo-encephalitis without clear causative agent or failure to respond to empirical treatment. A thorough immunologic workup and early start with antiviral therapy in any patient with a life-threatening course of HHV-6 infection is mandatory, because a severe HHV-6 infection can be the first indication of a primary immunodeficiency.

AB - OBJECTIVE: To report two previously healthy children with a life-threatening course of human herpes virus type 6 (HHV-6) infection and prolonged pediatric intensive care treatment.DESIGN: Case reports.SETTING: A 16 bed pediatric intensive care unit at a tertiary care children's hospital.PATIENTS: Two children with life-threatening HHV-6 disease.INTERVENTIONS: Both children were mechanically ventilated because of respiratory failure. A detailed viral and immunologic workup was performed and treatment with antiviral medication started.MEASUREMENTS: Polymerase chain reaction assays of plasma, cerebrospinal fluid, bronchoalveolar lavage, and lung biopsies yielded HHV-6 in both patients. Immunophenotyping and lymphocyte stimulation tests with both mitogens and antigens indicated an immunodeficiency in both patients.CONCLUSION: HHV-6 infection should be considered in infants and young children with respiratory failure or meningo-encephalitis without clear causative agent or failure to respond to empirical treatment. A thorough immunologic workup and early start with antiviral therapy in any patient with a life-threatening course of HHV-6 infection is mandatory, because a severe HHV-6 infection can be the first indication of a primary immunodeficiency.

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KW - DNA, Viral

KW - Female

KW - Herpesvirus 6, Human

KW - Humans

KW - Immunologic Deficiency Syndromes

KW - Intensive Care Units, Pediatric

KW - Male

KW - Polymerase Chain Reaction

KW - Roseolovirus Infections

KW - Severity of Illness Index

U2 - 10.1097/PCC.0b013e31819bb956

DO - 10.1097/PCC.0b013e31819bb956

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SN - 1529-7535

VL - 10

SP - e16-e18

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

IS - 2

ER -

Life-threatening human herpes virus-6 infection in early childhood: presenting symptom of a primary immunodeficiency?

Abstract

Keywords

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