Angioimmunoblastic lymphadenopathy with disseminated human herpesvirus 6 infection in a patient with acute myeloblastic leukemia

Leukemia
M DaibataI Miyoshi

Abstract

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 sequentia...Continue Reading

Citations

Jan 14, 2000·Critical Reviews in Oncology/hematology·M Peiris
Jan 31, 2007·International Journal of Hematology·Satsuki OwatariShuichi Hanada
Dec 14, 2018·Frontiers in Oncology·Eva EliassenStanley David Hudnall

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