6
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Recurrence of herpes simplex encephalitis associated with temozolomide chemoradiation for malignant glioma: a case report and review of the literature

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Although herpes simplex encephalitis is not classically considered an opportunistic infection, reactivation of herpes simplex is being seen increasingly in patients with cancer or immunosuppression. The authors present a patient with malignant glioma and HSV-1 encephalitis whose PCR-proven encephalitis recurred after temozolomide (TMZ) chemoradiation despite acyclovir therapy, and summarize details of four other cases of HSV-1 encephalitis associated with TMZ. The similarity among these cases raises the likely need for longer treatment courses and/or oral suppressive therapy in patients at risk for herpes simplex infections who are receiving TMZ.

          Related collections

          Most cited references13

          • Record: found
          • Abstract: not found
          • Article: not found

          A systematic review on the role of adjunctive corticosteroids in herpes simplex virus encephalitis: is timing critical for safety and efficacy?

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Herpes simplex encephalitis in patients with cancer.

            Case reports and animal models suggest that chemotherapy, corticosteroids and radiotherapy (RT) may increase the risk of herpes simplex encephalitis (HSE). We retrospectively examined cases of HSE at an academic hospital devoted to cancer care. Patients were identified by positive herpes simplex virus (HSV) polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) or by brain pathology. There were seven patients with HSE over a 12 year period, four of whom had received cranial RT. During this time, a total of 997 patients were treated with cranial RT, suggesting a greater incidence than the expected risk of two to four cases per million people per year in the general population. Five patients had recently received chemotherapy and three were on dexamethasone. MRI findings were typical; four patients had bilateral anterior temporal lesions and three had unilateral-temporal lesions. Four patients had a normal CSF white blood cell count, three of whom had prior RT and dexamethasone. Four patients were positive for HSV-1, and two for HSV-2. One patient had a negative CSF PCR for HSV, but autopsy confirmed active HSE. Though still rare, the risk of HSE may be increased in patients with cancer, especially in those receiving cranial RT. MRI findings were typical, but CSF white blood cell count was normal in four patients and one had negative CSF testing, suggesting that CSF results may be misleading in this population.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Temozolomide-modulated glioma proteome: role of interleukin-1 receptor-associated kinase-4 (IRAK4) in chemosensitivity.

              The current treatment for glioblastoma includes temozolomide (TMZ) chemotherapy, yet the mechanism of action of TMZ is not thoroughly understood. Here, we investigated the TMZ-induced changes in the proteome of the glioma-derived cell line (U251) by 2D DIGE. We found 95 protein spots to be significantly altered in their expression after TMZ treatment. MS identified four upregulated spots: aspartyl tRNA synthetase glutathione synthetase, interleukin-1 receptor-associated kinase-4 (IRAK4), and breast carcinoma amplified sequence-1 and one downregulated spot: optineurin. TMZ-induced regulation of these five genes was validated by RT-qPCR and Western blot analysis. RNAi-mediated knockdown of IRAK4, an important mediator of Toll-like receptors signaling and chemoresistance, rendered the glioma cells resistant to TMZ. High levels of IRAK4 induced upon TMZ treatment resulted in IRAK1 downregulation and inhibition of NFkB pathway. Endogenous IRAK4 protein, but not transcript levels in glioma cell lines, correlated with TMZ sensitivity. Thus, we have identified several TMZ-modulated proteins and discovered an important novel role for IRAK4 in determining TMZ sensitivity of glioma cells through its ability to inhibit Toll-like receptor signaling and NFkB pathway. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
                Bookmark

                Author and article information

                Journal
                Oxf Med Case Reports
                Oxf Med Case Reports
                omcr
                omcr
                Oxford Medical Case Reports
                Oxford University Press
                2053-8855
                April 2014
                12 March 2014
                : 2014
                : 1
                : 1-4
                Affiliations
                [1 ]Harvard Medical School , Boston, MA, USA
                [2 ]Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School , Boston, MA, USA
                [3 ]Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, USA
                [4 ]Department of Neurology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA
                [5 ]Department of Neurosurgery, University of Michigan , Ann Arbor, MI, USA
                [6 ]Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School , Boston, MA, USA
                [7 ]Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA
                Author notes
                [* ]Correspondence address. 75 Francis Street, Boston, MA 02115, USA. Tel: +1-617-732-5540; Fax: +1-617-264-6346; E-mail: jkatz@ 123456partners.org
                Article
                omu001
                10.1093/omcr/omu001
                4369964
                25988006
                91a4eb1f-4b27-4f15-8ca9-5a6b055843d7
                Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                : 4 January 2014
                : 24 January 2014
                : 29 January 2014
                Page count
                Pages: 4
                Categories
                1200
                Case Report

                Comments

                Comment on this article