Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis

A 72-year-old woman with rheumatoid arthritis was treated with methotrexate (MTX) and iguratimod. Upon examination of a liver tumor, blisters due to varicella-zoster virus (VZV) infection were observed. Despite oral administration of valacyclovir, she developed varicella pneumonia and meningoencepha...

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Detalles Bibliográficos
Autores principales: Ito, Noriaki, Masuda, Takeshi, Yamaguchi, Kakuhiro, Sakamoto, Shinjiro, Horimasu, Yasushi, Nakashima, Taku, Miyamoto, Shintaro, Iwamoto, Hiroshi, Fujitaka, Kazunori, Hamada, Hironobu, Chayama, Kazuaki, Hattori, Noboru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593163/
https://www.ncbi.nlm.nih.gov/pubmed/35249916
http://dx.doi.org/10.2169/internalmedicine.8413-21
Descripción
Sumario:A 72-year-old woman with rheumatoid arthritis was treated with methotrexate (MTX) and iguratimod. Upon examination of a liver tumor, blisters due to varicella-zoster virus (VZV) infection were observed. Despite oral administration of valacyclovir, she developed varicella pneumonia and meningoencephalitis. A VZV antibody test revealed reinfection. The liver tumor shrank after discontinuance of MTX, and polymerase chain reaction revealed the reactivation of the Epstein-Barr virus (EBV). Therefore, we were unable to deny MTX-associated lymphoproliferative disorder (MTX-LPD). This is the first case of a complication of pneumonia and meningoencephalitis due to VZV reinfection and EBV reactivation.

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