A case report of severe recurrent varicella in an ankylosing spondylitis patient treated with adalimumab – a new side effect after 15 years of usage
| Autor: | Jelena Prepolec, Mahmoud Al-Mufleh, Anita Atelj, Tomislava Skuhala, Andrija Stanimirović, Dalibor Vukelić |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Male Herpesvirus 3 Human Varicella virus Adalimumab Severe recurrent infection Pneumonia Case report 030106 microbiology Anti-Inflammatory Agents Acyclovir Case Report medicine.disease_cause lcsh:Infectious and parasitic diseases 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Chickenpox Psoriasis medicine Humans lcsh:RC109-216 Spondylitis Ankylosing 030212 general & internal medicine Pneumonitis Ankylosing spondylitis business.industry Varicella zoster virus medicine.disease Infectious Diseases Methotrexate Rheumatoid arthritis Immunology business Uveitis medicine.drug |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-4 (2019) |
| DOI: | 10.1186/s12879-019-3768-y |
| Popis: | Background: Tumor necrosis factor-α (TNF-α) antagonists, most of which are monoclonal antibodies, became a widespread treatment for autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel diseases, psoriasis, psoriatic arthritis, hidradenitis suppurativa and uveitis. Their use is based on the blockage of TNF-α, which plays an important role in granulomas formation, development of phagosomes, activation and differentiation of macrophages, immune response against viral pathogens. The multiple adverse effects of TNF-α inhibition have been identified, including a two-to four-fold increased risk of active tuberculosis and other granulomatous conditions and an increased occurrence of some other serious bacterial, fungal and certain viral infections. ----- Case presentation: A 34-year-old male patient with disseminated varicella and pneumonitis was admitted to our hospital. The diagnosis of varicella was established serologically by enzyme immunoassay (EIA) and by polymerase chain reaction confirmation of the virus in vesicular fluid. The patient has been receiving adalimumab and methotrexate for the last 3 years due to ankylosing spondylitis and was seropositive to varicella zoster virus prior to the introduction of TNF-α antagonists. Acyclovir was administered for 10 days with the resolution of clinical illness and radiological signs of pneumonitis. ----- Conclusion: Due to the use of biological agents, particularly TNF-α inhibitors, as a well-established therapy for some autoimmune diseases, new potential adverse events can be expected in the future and we wanted to point out one of them. To our knowledge this is the first case of recurrent disseminated varicella in a patient taking TNF-α antagonists. |
| Databáze: | OpenAIRE |
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