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Original Article
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Korean J Med. 2015;88(5):602-607. Published online May 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.5.602
- 비인두암 환자 중 동시항암화학방사선요법 후 발생한 단순 헤르페스 뇌염
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최혜진1, 이지은1, 홍숙희1, 전은경1, 이시원2, 김연실2, 강진형1
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1가톨릭대학교 의과대학 서울성모병원 종양내과
2가톨릭대학교 의과대학 서울성모병원 방사선종양학과
- Herpes Simplex Encephalitis after Concurrent Chemoradiotherapy in Nasopharyngeal Cancer: A Case Report
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Hye Jin Choi1, Jieun Lee1, Suk Hee Hong1, Eun Kyung Jeon1, Seawon Lee2, Yeon Shil Kim2, Jin Hyoung Kang1
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1Division of Medical Oncology, Departments of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Departments of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding author: Jin Hyoung Kang ,Tel: +82-2-2258-6043, Fax: +82-2-594-6043, Email: jinkang@catholic.ac.kr
- Received: February 3, 2014; Revised: April 1, 2014 Accepted: May 16, 2014.
- 동시항암화학방사선요법 또는 전뇌방사선 치료 등을 시행하는 환자의 경우 면역 반응의 저하로 인하여 HSE가 발병할 확률이 증가하며 임상증상 및 검사 소견이 비특이적이다. 따라서 발열 및 의식 변화가 나타나는 환자에서는 HSE를 감별 진단 중 하나로 고려해야 한다. 본 증례에서는 즉각적인 항바이러스 치료에 좋은 반응을 보였으며 비교적 양호한 임상경과를 보인, 동시항암화학방사선요법 시행 중에 병발한 HSE를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.
߽ɾ :단순 헤르페스 뇌염; 비인두암; 동시항암화학방사선요법
- Abstract
- Herpes simplex encephalitis (HSE) is a rare viral encephalitis in adults. A high (70%) mortality rate with serious complications has been reported even after active, appropriate management. The association between HSE and immune suppression is unclear, but there are case reports of cancer patients in which HSE concomitantly developed after whole brain radiation or high-dose steroid treatment. The clinical manifestations and laboratory findings of these patients are atypical compared to the general population. Although brain magnetic resonance images reveal typical HSE findings, cerebrospinal fluid (CSF) analysis might be normal in cancer patients. We report a case of HSE in a 48-year-old male diagnosed with nasopharyngeal cancer and treated with concurrent chemoradiation. This patient had a normal cell count in CSF, but HSE was finally diagnosed from positive polymerase chain reaction test results. After administration of acyclovir and systemic steroid treatment, the patient had a good clinical course with few neurologic sequelae.
Keywords :Herpes simplex encephalitis, Nasopharyngeal cancer, Chemoradiotherapy
