{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:25:37Z","timestamp":1761863137540},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,11,23]],"date-time":"2012-11-23T00:00:00Z","timestamp":1353628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe hyponatremia is a critical electrolyte abnormality in allogeneic stem cell transplantation (allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>) recipients and &gt;50% of cases of severe hyponatremia are caused by the syndrome of inappropriate secretion of antidiuretic hormone (<jats:styled-content style=\"fixed-case\">SIADH<\/jats:styled-content>). Here, we present a patient with rapidly progressive severe hyponatremia as an initial sign and symptom of human herpesvirus\u20106\u2013associated post\u2010transplantation acute limbic encephalitis (<jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">PALE<\/jats:styled-content>) after allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. A 45\u2010year\u2010old woman with acute lymphoblastic leukemia received unrelated bone marrow transplantation from a one locus\u2010mismatched donor at the <jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> locus. On day 21, she developed a generalized seizure and loss of consciousness with severe hyponatremia, elevated serum antidiuretic hormone (<jats:styled-content style=\"fixed-case\">ADH<\/jats:styled-content>), and decreased serum osmolality. A high titer of <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> was detected in cerebrospinal fluid. Treatment with foscarnet sodium and hypertonic saline was started with improvement of neurological condition within several days. Although an elevated serum <jats:styled-content style=\"fixed-case\">ADH<\/jats:styled-content>, low serum osmolality, and high urinary osmolality persisted for 2\u00a0months, she had no other recurrent symptoms of encephalitis. Our experience suggests that hyponatremia accompanied by <jats:styled-content style=\"fixed-case\">SIADH<\/jats:styled-content> should be recognized as a prodromal or concomitant manifestation of <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">PALE<\/jats:styled-content>, and close monitoring of serum sodium levels in high\u2010risk patients for <jats:styled-content style=\"fixed-case\">HHV<\/jats:styled-content>\u20106 <jats:styled-content style=\"fixed-case\">PALE<\/jats:styled-content> is necessary for immediate diagnosis and treatment initiation.<\/jats:p>","DOI":"10.1111\/tid.12029","type":"journal-article","created":{"date-parts":[[2012,11,23]],"date-time":"2012-11-23T09:40:33Z","timestamp":1353663633000},"source":"Crossref","is-referenced-by-count":16,"title":["Severe hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone developed as initial manifestation of human herpesvirus\u20106\u2013associated acute limbic encephalitis after unrelated bone marrow transplantation"],"prefix":"10.1111","volume":"15","author":[{"given":"T.","family":"Kawaguchi","sequence":"first","affiliation":[{"name":"Department of Hematology Chiba University Hospital Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Hematology Chiba University Hospital Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Kawajiri","sequence":"additional","affiliation":[{"name":"Department of Hematology Chiba University Hospital Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Hematology Chiba University Hospital Chiba 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