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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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
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author Ito, Noriaki
Masuda, Takeshi
Yamaguchi, Kakuhiro
Sakamoto, Shinjiro
Horimasu, Yasushi
Nakashima, Taku
Miyamoto, Shintaro
Iwamoto, Hiroshi
Fujitaka, Kazunori
Hamada, Hironobu
Chayama, Kazuaki
Hattori, Noboru
author_facet Ito, Noriaki
Masuda, Takeshi
Yamaguchi, Kakuhiro
Sakamoto, Shinjiro
Horimasu, Yasushi
Nakashima, Taku
Miyamoto, Shintaro
Iwamoto, Hiroshi
Fujitaka, Kazunori
Hamada, Hironobu
Chayama, Kazuaki
Hattori, Noboru
author_sort Ito, Noriaki
collection PubMed
description 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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spelling pubmed-95931632022-11-07 Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis Ito, Noriaki Masuda, Takeshi Yamaguchi, Kakuhiro Sakamoto, Shinjiro Horimasu, Yasushi Nakashima, Taku Miyamoto, Shintaro Iwamoto, Hiroshi Fujitaka, Kazunori Hamada, Hironobu Chayama, Kazuaki Hattori, Noboru Intern Med Case Report 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. The Japanese Society of Internal Medicine 2022-03-05 2022-10-01 /pmc/articles/PMC9593163/ /pubmed/35249916 http://dx.doi.org/10.2169/internalmedicine.8413-21 Text en Copyright © 2022 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ito, Noriaki
Masuda, Takeshi
Yamaguchi, Kakuhiro
Sakamoto, Shinjiro
Horimasu, Yasushi
Nakashima, Taku
Miyamoto, Shintaro
Iwamoto, Hiroshi
Fujitaka, Kazunori
Hamada, Hironobu
Chayama, Kazuaki
Hattori, Noboru
Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title_full Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title_fullStr Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title_full_unstemmed Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title_short Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
title_sort pneumonia and meningoencephalitis due to varicella-zoster virus reinfection and epstein-barr virus reactivation in a patient with rheumatoid arthritis
topic Case Report
url 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
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