Hemophagocytic syndrome in primary human herpes virus-6 infection: a rare condition after liver transplantation

Human herpes virus-6 primary infection generally occurs during the first th ree years of childhood and is generally asymptomatic. The virus has been id entified as the causal agent of exanthemum subitum in children or mononucle osis-like disease in adults, and may also cause several disorders in immuno compromised patients. We report a clinical case of acute rejection observed 29 days after orthotopic liver transplantation in a 22-month-old child ass ociated with acute hepatitis and a hemophagocytic syndrome on day 38. Human herpes virus-6 primary infection was identified based on several virologic al tests: seroconversion, detection of viral DNA in bone marrow and periphe ral blood after polymerase chain reaction, and detection of viral replicati on in peripheral blood. Tests for Epstein-Barr virus, cytomegalovirus or Pa rvovirus B19 infections were negative. After treatment by ganciclovir (Cyme van(R)), clinical status improved.