Proven Epstein-Barr encephalitis with negative EBV-DNA load in cerebrospinal fluid after allogeneic hematopoietic stem cell transplantation in a child with acute lymphoblastic leukemia.

Abstract:

:We report a case of EBV encephalitis in a seven-yr-old child with Ph+ ALL. Two months after an allogeneic HSCT from his HLA mismatched mother, the patient showed an altered sensorium, generalized seizures, and a left hemiparesis. Brain MRI demonstrated multiple lesions highly suggestive for viral encephalitis. Blood and CSF PCR analyses were negative for the most common viruses involved in immunocompromised patients including EBV. A cerebral biopsy was performed, which showed intense gliosis and perivascular lymphocytic cuffing. PCR analysis performed on brain tissue was positive only for the EBV genome, while extensive investigations for other viral infections were negative. The patient's neurological symptoms rapidly worsened and he died two months later. This case report suggests that in patients presenting neurological and radiological signs of encephalitis after an HSCT, an EBV involvement should be considered, even in the absence of CSF and blood PCR virus detection.

journal_name

Pediatr Transplant

authors

Barberi W,Perrone S,Iori AP,Torelli GF,Testi AM,Moleti ML,Ceglie T,Papoff P,Caresta E,Antonelli M,Gianno F,Melone A,Badiali M,Giangaspero F,Foà R,Gentile G

doi

10.1111/petr.12386

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

E19-24

issue

1

eissn

1397-3142

issn

1399-3046

journal_volume

19

pub_type

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