1/13. Bell's palsy during interferon therapy for chronic hepatitis c infection in patients with haemorrhagic disorders.Two adult patients with life-long severe haemorrhagic disorders commenced on interferon-alpha2b therapy for chronic hepatitis c infection. Both developed Bell's palsy several weeks after commencing therapy, They were started on steroids and, in addition, the first patient discontinued interferon-alpha2b therapy while the second patient elected to continue with therapy. In both cases facial paralysis improved over the ensuing weeks. Bell's palsy is often idiopathic but has been reported. in association with herpesviruses. It is not a recognised complication of chronic hepatitis b or C infection, or interferon-alpha2b therapy. However, the interferons are associated with numerous adverse reactions including various neuropsychiatric manifestations and neurological syndromes. There are several reports of nerve palsies, including optic tract neuropathy, occurring during interferon therapy, and immune-based mechanisms are thought to play a role in the aetiopathogenesis. No reports of Bell's palsy in association with interferon therapy were identified in our literature search, although one possible case has been reported to the Committee of safety in medicine. Although Bell's palsy in our patients may have occurred by chance, a neuropathic effect of interferon-alpha2b on the facial nerve cannot be excluded and we urge physicians using interferons to be aware of this potential side-effect.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
2/13. Chronic graft-versus-host disease after hematopoietic cell transplantation presenting as an acute hepatitis.A variety of illnesses involving the gut and liver follow hematopoietic cell transplantation (HCT). A 20 yr-old white male developed severe acute hepatitis 36 wk (day 252) after matched, unrelated, allogeneic HCT for chronic myelogenous leukemia (CML). Mild skin graft-versus-host disease (GVHD) had occurred at about 20 wk (day 140) after transplant. liver biopsy showed bile duct injury and a diffuse lobular injury pattern most consistent with a GVHD variant and not reminiscent of drug-induced or viral hepatitis. No findings suggestive of herpesvirus, adenovirus, or varicella-zoster virus were found. High-dose steroids resulted in marked improvement of his liver enzyme levels. We report this patient as representing the acute hepatitic presentation of chronic GVHD of the liver.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
3/13. Natural killer cell-type body cavity lymphoma following chronic active Epstein-Barr virus infection.We describe a 69-year-old female who developed natural killer cell-type body cavity lymphoma following chronic active Epstein-Barr virus (CAEBV) infection. Examination of the patient's pleural effusion revealed large abnormal lymphocytes, which were CD2( ), CD7( ), CD30( ), CD56( ), CD3(-), and CD4(-). No rearrangement of T cell receptor genes was detected. Clonal proliferation of Epstein-Barr virus (EBV)-infected cells in pleural effusion was demonstrated by Southern blot hybridization analysis. Human herpesvirus type-8 (HHV-8) dna was not detected in these cells. The patient achieved a complete remission with combination chemotherapy. Prior to the clinical onset of lymphoma, high fever of unknown origin had persisted for 21 months. IgG antibodies to EBV-viral capsid antigen and to EBV-early antigens, types D and R were not high (1:160 and less than 1:10, respectively). Two months after the onset of fever, however, retrospective quantitative PCR assay revealed a high EBV dna load in plasma, indicating that CAEBV infection had been the cause of the patient's recurrent fever. The remarkable features of this case are (i) the development of lymphoma following CAEBV infection that demonstrated a normal pattern of EBV-specific antibodies, (ii) the development of HHV-8-negative body cavity lymphoma, and (iii) the effectiveness of combination chemotherapy.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
4/13. Specific autologous cytotoxic T lymphocytes for chronic varicella in a liver transplanted child.Infections by herpesviruses may have severe complications in liver transplant patients. Although prophylactic varicella zoster virus vaccination is strongly recommended and widely applied, severe infection may still occur. We report the case of systemic chronic varicella, which developed in a liver allograft recipient, unresponsive to antiviral drug treatment, successfully treated by varicella zooster-specific CTL. Graft failure ensued, likely, because of massive cytolysis of infected hepatocytes. The patient, who was re-transplanted in the absence of signs of varicella zooster reactivation, is now well and disease free 3 yr after second liver transplant.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
5/13. vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency.Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.- - - - - - - - - - ranking = 6keywords = herpesvirus (Clic here for more details about this article) |
6/13. Epstein-Barr virus genome-positive T lymphocytes in a boy with chronic active EBV infection associated with Kawasaki-like disease.Epstein-Barr virus (EBV), a ubiquitous human herpesvirus and an aetiological agent of infectious mononucleosis, has a unique tropism for B lymphocytes. Clinical and laboratory features of chronic active EBV infections are chronic or persistent infectious mononucleosis-like symptoms and high antibody titre against early antigens (EA). Kawasaki disease (KD), aetiology unknown, is thought to be self-limited immunologically mediated vasculitis. Clinical features of KD are fever, rash, mucositis, lymphadenopathy and coronary artery damage. We report here a child with chronic active EBV infection accompanied by dilatation of coronary arteries. All the EBV-determined nuclear antigen (EBNA)-positive lymphocytes had exclusively CD4 antigen, as revealed by dual staining immunofluorescence analysis. Southern blot hybridization showed that the purified CD4 cells harboured EBV genome.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
7/13. Chronic progressive varicella-zoster virus encephalitis in an AIDS patient.A patient with AIDS developed chronic, progressive encephalitis. Pathologic changes indicated that the encephalitis was produced primarily by a human herpesvirus. Hybridization of radiolabeled rna probes transcribed from cloned dna fragments of varicella-zoster virus (VZV), herpes simplex virus, cytomegalovirus, and the human immunodeficiency virus to dna extracted from the patient's brain identified VZV as the causative agent. The results suggest that VZV should be considered in the differential diagnosis of chronic encephalitis of unknown etiology, particularly in immunosuppressed patients.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
8/13. Chronic infection with cutaneous herpes simplex in a patient with systemic lupus erythematosus.A 68-year-old black woman with systemic lupus erythematosus being managed by systemic corticosteroids developed large ulcerated lesions in a dermatomal distribution on the flank and abdomen. Subsequently, large ulcers developed progressively in the perianal region, the buttocks, the perivaginal region, and the thighs. The clinical diagnosis was vasculitis of systemic lupus erythematosus. biopsy from the margin of an ulcer showed changes in the epidermis that are specific for infections by herpesvirus. Electron microscopy revealed viral particles of herpesvirus. Cultures from the perianal lesions grew Herpesvirus hominis. This is the first report to our knowledge of "chronic cutaneous herpes infection" in a patient with systemic lupus erythematosus.- - - - - - - - - - ranking = 2keywords = herpesvirus (Clic here for more details about this article) |
9/13. Chronic myelopathy associated with human herpesvirus-6.Human herpesvirus-6 (HHV-6) is implicated in a variety of neurologic diseases. We report a previously healthy elderly woman with progressive spastic paraparesis. At autopsy the spinal cord showed widespread demyelination, axonal loss, and chronic inflammation. HHV-6 dna was amplified, using polymerase chain reaction, from spinal cord tissue, and glial cells were immunoreactive with an HHV-6 antibody. These findings suggest that HHV-6 may cause myelopathy.- - - - - - - - - - ranking = 5keywords = herpesvirus (Clic here for more details about this article) |
10/13. Isolation of human herpesvirus 7 from a child with symptoms mimicking chronic Epstein-Barr virus infection.Human herpesvirus-7 (HHV-7), which is a newly identified human herpesvirus with an unknown pathologic role, was isolated from a 5-year-old boy suffering from fever, hepatosplenomegaly and pancytopenia. Although the clinical course was similar to that of chronic active Epstein-Barr virus infection, no viruses other than HHV-7 were isolated. This finding raises the possibility that HHV-7 played a pathogenic role in the present patient.- - - - - - - - - - ranking = 6keywords = herpesvirus (Clic here for more details about this article) |
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