02 December 2025
: Case report 
Neuropsychiatric Symptoms After HHV-6 Encephalitis in an Immunocompetent Child: A Case Report
Unusual clinical course, Challenging differential diagnosis
Dima Habanjar ABCEF 1, Samah Trad EF 1, Daniel Charouf EF 1, Siham Kreidly EF 1, Rose-Mary Boustany
ABCDEF 1,2,3*
DOI: 10.12659/AJCR.950405
Am J Case Rep 2025; 26:e950405
Table 1 Patient laboratory results in cerebrospinal fluid and blood at presentation.
| Patient result | Reference range | |
|---|---|---|
| WBC (serum) | 11500/mm | 5000–17000/mm |
| Neutrophils (serum) | 45% | 35–60% |
| Lymphocytes (serum) | 38% | 30–65% |
| SGOT (serum) | 34 IU/L | 0–50 IU/L |
| ASO (serum) | 544 IU/mL | ≤150 IU/mL |
| Anti-dsDNA (serum) | <20 IU/mL | <20 IU/mL |
| TSH | 1.86 μU/mL | 0.700–5.790 μU/mL |
| TPO | 0.1 IU/mL | <10 IU/mL |
| TgAB | 2 IU/mL | <15 IU/mL |
| IgA (blood) | 0.61 g/L | 0.27–1.95 g/L |
| IgG (blood) | 9.43 g/L | 5.04–14.65 g/L |
| IgQ: IgM (blood) | 0.96 g/L | 0.24–2.10 g/L |
| WBC (CSF) | 7/mm | ≤5/mm |
| RBC (CSF) | 1/mm | ≤0/mm |
| Protein (CSF) | 0.18 g/L | 0.10–0.50 g/L |
| Glucose (CSF) | 56 mg/dL | 40–70 mg/dL |
| Meningitic panel* (CSF) | HHV-6 detected | Not detected |
| CASPR-2 antibodies (S/C) | <1: 1 | <1: 1 |
| LGI1 antibodies (S/C) | <1: 1 | <1: 1 |
| DPPX antibodies (S/C) | <1: 2 | <1: 2 |
| MOG antibodies (S/C) | <1: 1 | <1: 1 |
| Aquaporin-4 antibodies (S/C) | <1: 1 | <1: 1 |
| NMDA antibodies (S/C) | <1: 1 | <1: 1 |
| GAD antibodies (serum) | 5.9 IU/mL | <17.0 IU/mL |
| GABA B-receptor antibodies (CSF) | Negative | Negative |
| IgG (CSF) | 9.2 mg/L | ≤40 mg/L |
| IgG index | 0.33 | 0.30–0.77 |
| Oligoclonal banding | Negative | Negative |
| CSF – cerebrospinal fluid; WBC – white blood cells; SGOT – serum glutamic-oxaloacetic transaminase; ASO – anti-streptolysin O; RBC – red blood cells; S/C – serum and cerebrospinal fluid; CASPR-2 – contactin-associated protein-2; LGI1 – leucine-rich glioma-inactivated 1; DPPX – dipeptidyl-peptidase-like protein 6; MOG – myelin oligodendrocyte glycoprotein; NMDA – N-methyl-D-aspartate; GABA – gamma-aminobutyric acid; GAD – glutamic acid decarboxylase; TSH – thyroid-stimulating hormone; TPO – anti-thyroid peroxidase antibodies; TgAB – thyroglobulin antibody. * Meningitic panel includes: , , , , , Cytomegalovirus, Enterovirus, Herpes simplex virus 1, Herpes simplex virus 2, Human herpesvirus 6, Human parechovirus, Varicella zoster virus, , and K1. | ||