A Case of Limbic Encephalitis Developed after Allogeneic Stem Cell Transplantation

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.

Psychological Status of Children with Type I Diabetes Mellitus: Maternal Psychologic State in Diabetic Children with Depressive Mood / 대한소아내분비학회지

OBJECTIVE: The aim of this study was to see an incidence of depression, and to see the characteristics of demographic variables, maternal psychologic state and family environments in adolescent children with type I DM who was in depressive mood. METHODS: Among children with type I DM who participated in a diabetes summer camp which was held in Daegu between August 6th and 10th, 2004, authors sent questainnaires which included CDI/ BDI for children, MMPI and SCL-90 for patients' mothers, and FES which mothers were asked to respond to the 40 patients' house after gaining parents and patients' permission by telephoning. Twenty-three out of 40 patients completed these questainnaires. Study patients consisted of 10 boys and 13 girls. Their mean age was 13.3 years. RESULTS: There were significant differences in maternal MMPI and SCL-90 between depressive and non-depressive group. Among the maternal MMPI, the t-scores of hypochondriasis and hysteria in depressive group were higher than those of non- depressive group. And among the dimension of SCL-90, t-score of depression, anxiety, phobic anxiety and psychoticism in depressive group were higher than those of non-depressive group (P<0.05). These findings were concordant with prior findings that the mothers of diabeteic childen were more depressed and anxious than the mothers of control children. CONCLUSION: Though there are several limitation to this study, this study found high incidence rate in children with type I diabetes, and replicate prior findings supporting the effect of type I diabetes on the maternal psychologic state and family functioning. Larger size group is necessary to confirm our findings.