RESUMO
RATIONALE: Human herpesvirus 6 (HHV-6) has been demonstrated to be the causative agent in roseola infantum. It has been suggested that HHV-6 may have neurotropic properties and be involved in the pathogenesis of febrile seizures in infants. We describe a case-control study to examine the hypothesis that acute HHV-6 infection occurs more commonly in children with febrile seizures than in controls. METHODS: Patients presenting with a first or second febrile seizure between 6 months and 2 years of age were entered in the study. Control patients did not have a seizure but had similar inclusion and exclusion criteria. Specimens were obtained for HHV-6 viral serology and polymerase chain reaction in the acute stage and approximately 2 weeks later. A diagnosis of HHV-6 infection was based on HHV-6-specific IgM and IgG serology and HHV-6 polymerase chain reaction of peripheral blood mononuclear cells and saliva. RESULTS: Eighty-six patients (45 with febrile seizures; 41 controls) were enrolled. The HHV-6 infection status could be determined in only 68 patients (35 with febrile seizures; 33 controls). Acute HHV-6 infection was identified in 15 of 35 febrile seizure patients and in 15 of 33 controls. Evidence of past HHV-6 infection was demonstrated in 13 febrile seizure patients and in 8 controls. CONCLUSIONS: The incidence of primary HHV-6 infection is similar in patients with febrile seizures and age-matched controls. HHV-6 does not seem to be a major factor in the pathogenesis of first and second febrile seizures.
Assuntos
Proteínas do Capsídeo , Infecções por Herpesviridae/complicações , Herpesvirus Humano 6/isolamento & purificação , Convulsões Febris/complicações , Doença Aguda , Anticorpos Antivirais/análise , Antígenos Virais/imunologia , Estudos de Casos e Controles , Líquido Cefalorraquidiano/virologia , Pré-Escolar , Citomegalovirus/imunologia , Primers do DNA/química , DNA Viral/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/complicações , Técnica Indireta de Fluorescência para Anticorpo , Infecções por Herpesviridae/diagnóstico , Infecções por Herpesviridae/virologia , Herpesvirus Humano 1/imunologia , Herpesvirus Humano 6/genética , Humanos , Incidência , Lactente , Masculino , Reação em Cadeia da Polimerase , Convulsões Febris/diagnóstico , Convulsões Febris/virologiaRESUMO
A child with idiopathic systemic capillary leak syndrome had four episodes between 3 and 3 years 9 months of age, all characterized by the sudden onset of hypovolemic shock without any obvious triggering factor. Between the attacks she is well and free of symptoms. Early establishment of intravenous access facilitates volume replacement during the acute episodes.
