Herpes zoster meningitis in a rheumatoid arthritis patient treated with tofacitinib

被引:1
|
作者
Nakamura, Yoshihiro [1 ]
Honda, Daiyu [2 ]
Takizawa, Naoho [1 ]
Fujita, Yoshiro [1 ]
机构
[1] Chubu Rosai Hosp, Dept Rheumatol, Nagoya, Aichi, Japan
[2] Nagoya Daiichi Sekijuji Byoin, Dept Neurol, Nagoya, Aichi, Japan
关键词
dermatology; infectious diseases; vaccination; immunisation; infection (neurology); rheumatoid arthritis; VACCINE; SAFETY;
D O I
10.1136/bcr-2021-247276
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A man in his 70s with rheumatoid arthritis presented with seizures and coma and was transferred to our emergency department. Two months prior to admission, he started to take tofacitinib 10 mg/day. On admission, we noted a rash with a blister on the forehead, and herpes zoster was diagnosed. Cerebrospinal fluid examination suggested meningitis. An MRI of the brain showed no abnormality. Based on these findings, he was suspected with herpes zoster meningitis. We discontinued tofacitinib and treated the patient with intravenous acyclovir for 2 weeks. He regained complete consciousness, but right forehead skin lesion, severe vision loss in the right eye and right facial nerve paralysis remained as sequelae. Six weeks after admission, we restarted tofacitinib with oral valaciclovir as antiviral prophylaxis. Two years after admission, we administered Shingrix, an adjuvant recombinant vaccine for herpes zoster, and discontinued oral valaciclovir.
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页数:3
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