Acute Encephalopathy Following Exanthem Subitum Caused by Human Herpesvirus-6

Recent human herpesvirus 6 (HHV-6) infection was detected in cases of exanthem subitum (ES) involving four children, aged 10 to 24 months, between April and August 1994, in Belém, Brazil. By using the indirect immunofluorescence antibody assay (IFA), significant increases (at least eight times) in antibody concentrations were noted from the acute to the convalescent serum samples, with titers ranging from <1:10/1:80 to <1:10/1:640 (patients 3 and 2, respectively). All children had high fever (over 39ºC) for three days, followed by generalized, maculo-papular skin rash. A physical examination of the children also revealed concomitant, cervical lymph node swelling and tonsillar pharyngitis in two of them.

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Distribution of Antibodies to a Causative Agent of Exanthem Subitum (Human Herpesvirus-6) in Healthy Individuals

PEDIATRICS ◽

10.1542/peds.84.4.675 ◽

1989 ◽

Vol 84 (4) ◽

pp. 675-677

Author(s):

Tetsushi Yoshikawa ◽

Sadao Suga ◽

Yoshizo Asano ◽

Takehiko Yazaki ◽

Hiroshi Kodama ◽

...

Keyword(s):

Cord Blood ◽

Causative Agent ◽

Human Herpesvirus ◽

Immunofluorescence Assay ◽

Healthy Individuals ◽

Human Herpesvirus 6 ◽

Exanthem Subitum ◽

Adolescents And Adults ◽

Positive Rate ◽

Herpesvirus 6

The transfer of IgG antibodies to a causative agent of exanthem subitum (human herpesvirus-6) from mother to infant was examined with an indirect immunofluorescence assay. Of 20 mothers, 85% had the antibody more than 1:10, and the significantly higher level of the antibody was found in the cord blood with a positive rate of 95%. A mean ratio of cord blood to maternal antibody titer was 1.63. A total of 301 sera from healthy individuals was examined for the age-specific prevalence of antibody to the virus. In the first 2 months of life, 87% of infants had the antibody; the positive rate and the level of antibody decreased during the first 6 months of life with the lowest positive rate of 6% at 4 to 5 months of age. After 6 months of age, they increased gradually and reached the highest level at 1 year of age with the positive rate of 86%. From 2 years of age, the prevalence of the antibody was almost stable (69% to 76%) and similar to those in adolescents and adults.

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IgM Neutralizing Antibody Responses to Human Herpesvirus-6 in Patients with Exanthem Subitum or Organ Transplantation

Microbiology and Immunology ◽

10.1111/j.1348-0421.1992.tb02047.x ◽

1992 ◽

Vol 36 (5) ◽

pp. 495-506 ◽

Cited By ~ 39

Author(s):

Sadao Suga ◽

Tetsushi Yoshikawa ◽

Yoshizo Asano ◽

Toshihiko Nakashima ◽

Takehiko Yazaki ◽

...

Keyword(s):

Organ Transplantation ◽

Human Herpesvirus ◽

Neutralizing Antibody ◽

Antibody Responses ◽

Human Herpesvirus 6 ◽

Exanthem Subitum ◽

Herpesvirus 6

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The predictive value of uvulo-palatoglossal junctional ulcers as an early clinical sign of exanthem subitum due to human herpesvirus 6

Journal of Clinical Virology ◽

10.1016/s1386-6532(00)00077-9 ◽

2000 ◽

Vol 17 (2) ◽

pp. 83-90 ◽

Cited By ~ 8

Author(s):

K.B Chua ◽

S.K Lam ◽

S AbuBakar ◽

S.T Lim ◽

M Paranjothy ◽

...

Keyword(s):

Clinical Sign ◽

Predictive Value ◽

Human Herpesvirus ◽

Human Herpesvirus 6 ◽

Exanthem Subitum ◽

Herpesvirus 6

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Serum and cerebrospinal fluid levels of cytokines in acute encephalopathy associated with human herpesvirus-6 infection

Brain and Development ◽

10.1016/j.braindev.2008.11.005 ◽

2009 ◽

Vol 31 (10) ◽

pp. 731-738 ◽

Cited By ~ 54

Author(s):

Takashi Ichiyama ◽

Yoshinori Ito ◽

Masaya Kubota ◽

Tsutomu Yamazaki ◽

Kazuyuki Nakamura ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Human Herpesvirus ◽

Acute Encephalopathy ◽

Human Herpesvirus 6 ◽

Cerebrospinal Fluid Levels ◽

Herpesvirus 6 ◽

Fluid Levels

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Exanthem Subitum and Antibody to Human Herpesvirus-6

The Journal of Infectious Diseases ◽

10.1093/infdis/159.4.750 ◽

1989 ◽

Vol 159 (4) ◽

pp. 750-752 ◽

Cited By ~ 47

Author(s):

K. Ueda ◽

K. Kusuhara ◽

M. Hirose ◽

K. Okada ◽

C. Miyazaki ◽

...

Keyword(s):

Human Herpesvirus ◽

Human Herpesvirus 6 ◽

Exanthem Subitum ◽

Herpesvirus 6

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Human herpesvirus 6.

Clinical Microbiology Reviews ◽

10.1128/cmr.10.3.521 ◽

1997 ◽

Vol 10 (3) ◽

pp. 521-567 ◽

Cited By ~ 277

Author(s):

D K Braun ◽

G Dominguez ◽

P E Pellett

Keyword(s):

Human Herpesvirus ◽

Etiologic Agent ◽

Childhood Illness ◽

The Other ◽

Immunocompromised Patients ◽

Human Herpesvirus 6 ◽

Exanthem Subitum ◽

The Central Nervous System ◽

The Common ◽

Herpesvirus 6

Human herpesvirus 6 variant A (HHV-6A) and human herpesvirus 6 variant B (HHV-6B) are two closely related yet distinct viruses. These visuses belong to the Roseolovirus genus of the betaherpesvirus subfamily; they are most closely related to human herpesvirus 7 and then to human cytomegalovirus. Over 95% of people older than 2 years of age are seropositive for either or both HHV-6 variants, and current serologic methods are incapable of discriminating infection with one variant from infection with the other. HHV-6A has not been etiologically linked to any human disease, but such an association will probably be found soon. HHV-6B is the etiologic agent of the common childhood illness exanthem subitum (roseola infantum or sixth disease) and related febrile illnesses. These viruses are frequently active and associated with illness in immunocompromised patients and may play a role in the etiology of Hodgkin's disease and other malignancies. HHV-6 is a commensal inhabitant of brains; various neurologic manifestations, including convulsions and encephalitis, can occur during primary HHV-6 infection or in immunocompromised patients. HHV-6 and distribution in the central nervous system are altered in patients with multiple sclerosis; the significance of this is under investigation.

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