Korean J Hematol.  2006 Dec;41(4):297-301. 10.5045/kjh.2006.41.4.297.

A Case of Limbic Encephalitis Developed after Allogeneic Stem Cell Transplantation

• Park NS
• Park SE
• Chun JM
• Park NH
• Yang YJ
• Yun KW
• Son EH
• Yun HJ
• Jo DY
• Song CJ
• Kim S

• KMID: 2305217
• DOI: http://doi.org/10.5045/kjh.2006.41.4.297

Abstract

Limbic encephalitis is a rare neurological syndrome, which develops after stem cell transplantation, and is characterized by a series of neurological symptoms, including retrograde amnesia, behavioral disturbance, and progressive intellectual deterioration and high signal intensity in the hippocampus on magnetic resonance imaging (MRI). Herein is described the case of a patient with limbic encephalitis, which developed after allogeneic bone marrow transplantation, and was possibly due to HHV-6 infection. An 18-year-old man, with acute lymphoid leukemia, who underwent HLA-matched unrelated donor bone marrow transplantation, developed a fever and chill accompanied by neurological symptoms, including behavioral disturbance and retrograde amnesia, during the bone marrow recovery phase. A brain MRI revealed bright signal-intensity in both hippocampi. Examination of his cerebrospinal fluid suggested viral encephalitis. Based on these findings, a diagnosis of viral limbic encephalitis was highly suspected. Tests for casual causes of viral limbic encephalitis, including the CMV, HZV and HSV-1 and 2, in serum or CSF were all negative. The encephalitis responded well to ganciclovir therapy.

Keyword

Limbic encephalitis; Allogeneic stem cell transplantation; HHV-6

MeSH Terms

Adolescent
Amnesia, Retrograde
Bone Marrow
Bone Marrow Transplantation
Brain
Cerebrospinal Fluid
Diagnosis
Encephalitis
Encephalitis, Viral
Fever
Ganciclovir
Herpesvirus 1, Human
Herpesvirus 6, Human
Hippocampus
Humans
Limbic Encephalitis*
Magnetic Resonance Imaging
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Stem Cell Transplantation*
Stem Cells*
Unrelated Donors
Ganciclovir

Figure

• 

  Fig. 1 Brain magnetic resonance imaging. T1-weighted image (A) and T2-weighted image (B) showed low signal intensity lesions and high signal intensity lesions, respectively, in both hippocampus (arrows).

• 

  Fig. 2 EEG findings.

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