kaffiend
Senior Member
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This case study is in press in the Journal of Clinical Virology. The virus was not found in the heart on biopsy; only post-mortem on autopsy.
A fatal case of Human Herpesvirus 6 chronic myocarditis in an immunocompetent adult
Nicolas Leveque a,? , Camille Boulagnon b , Camille Brasselet c , Franc ? ois Lesaffre c , David Boutolleau d , Damien Metzc, Paul Fornesb, Laurent Andreolettia
a Clinical and Molecular Virology Unit, University Hospital and EA-4303 Faculty of Medicine, Reims, France
b Pathology Department, University Hospital, Reims, France
c Cardiology Department, University Hospital, Reims, France
d Virology Department, Piti-Salptrire University Hospital, AP-HP and UPMC Univ Paris 06, ER1 DETIV, Paris, France
Background: Human Herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis in immunocompromised or immunocompetent patients. However the physiopathological mechanisms of HHV-6 related acute myocarditis and the involvement of subsequent HHV-6 reactivation phases in the development of chronic cardiomyopathies remain to be assessed.
Objectives: To describe a case of fatal HHV-6 chronic myocarditis in an immunocompetent adult.
Study design: Case report and detailed histological and viral diagnoses by combination of histol- ogy/immunohistochemistry and polymerase chain reaction techniques on cardiac tissues.
Results: Histopathological analysis of ventricular tissues showed large interstitial and scarring fibrotic areas with a moderate mononuclear cell infiltrate compatible with histological aspect of chronic myocarditis. Detection of both HHV-6 by real-time PCR and viral glycoproteins in mononuclear and endothelial cells by immunohistochemistry evidenced an ongoing cardiac HHV-6 replication with viral late protein synthesis activity.
Conclusions: This case report indicates that HHV-6 can establish a chronic active myocarditis leading to heart failure in immunocompetent subjects.
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A fatal case of Human Herpesvirus 6 chronic myocarditis in an immunocompetent adult
Nicolas Leveque a,? , Camille Boulagnon b , Camille Brasselet c , Franc ? ois Lesaffre c , David Boutolleau d , Damien Metzc, Paul Fornesb, Laurent Andreolettia
a Clinical and Molecular Virology Unit, University Hospital and EA-4303 Faculty of Medicine, Reims, France
b Pathology Department, University Hospital, Reims, France
c Cardiology Department, University Hospital, Reims, France
d Virology Department, Piti-Salptrire University Hospital, AP-HP and UPMC Univ Paris 06, ER1 DETIV, Paris, France
Background: Human Herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis in immunocompromised or immunocompetent patients. However the physiopathological mechanisms of HHV-6 related acute myocarditis and the involvement of subsequent HHV-6 reactivation phases in the development of chronic cardiomyopathies remain to be assessed.
Objectives: To describe a case of fatal HHV-6 chronic myocarditis in an immunocompetent adult.
Study design: Case report and detailed histological and viral diagnoses by combination of histol- ogy/immunohistochemistry and polymerase chain reaction techniques on cardiac tissues.
Results: Histopathological analysis of ventricular tissues showed large interstitial and scarring fibrotic areas with a moderate mononuclear cell infiltrate compatible with histological aspect of chronic myocarditis. Detection of both HHV-6 by real-time PCR and viral glycoproteins in mononuclear and endothelial cells by immunohistochemistry evidenced an ongoing cardiac HHV-6 replication with viral late protein synthesis activity.
Conclusions: This case report indicates that HHV-6 can establish a chronic active myocarditis leading to heart failure in immunocompetent subjects.
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