Varicella-zoster virus vasculopathy in a patient with multiple sclerosis receiving natalizumab
Elmståhl, Anna ; Buchwald, Fredrik LU and Ilinca, Andreea LU
(2023)
In BMJ Case Reports
16(12).
- Abstract
We present a case of a woman in her 30s with relapsing-remitting multiple sclerosis, treated with natalizumab, who developed ophthalmic varicella zoster virus (VZV) infection, with subsequent vasculopathy causing cerebral ischaemic lesions. She was treated with acyclovir, prednisolone and acetylsalicylic acid and fully recovered. VZV vasculopathy is associated with stroke and immunomodulating treatments may increase the risks of these adverse events. To date, nine VZV-related vasculopathy cases in patients treated with natalizumab have been reported in English literature and are summarised in this paper. Although rare, VZV intracerebral vasculopathy is an important differential diagnosis in patients with unexplained new-onset... (More)
We present a case of a woman in her 30s with relapsing-remitting multiple sclerosis, treated with natalizumab, who developed ophthalmic varicella zoster virus (VZV) infection, with subsequent vasculopathy causing cerebral ischaemic lesions. She was treated with acyclovir, prednisolone and acetylsalicylic acid and fully recovered. VZV vasculopathy is associated with stroke and immunomodulating treatments may increase the risks of these adverse events. To date, nine VZV-related vasculopathy cases in patients treated with natalizumab have been reported in English literature and are summarised in this paper. Although rare, VZV intracerebral vasculopathy is an important differential diagnosis in patients with unexplained new-onset neurological symptoms after a herpes zoster infection. Treatment guidelines for VZV vasculopathy and for continuing treatment of multiple sclerosis after such an event are currently not established.
(Less)
- author
- Elmståhl, Anna
; Buchwald, Fredrik
LU
and Ilinca, Andreea
LU
- organization
- publishing date
- 2023-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Drugs: CNS (not psychiatric), Headache (including migraines), Infection (neurology), Multiple sclerosis, Stroke
- in
- BMJ Case Reports
- volume
- 16
- issue
- 12
- article number
- e254114
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:38081745
- scopus:85179647976
- ISSN
- 1757-790X
- DOI
- 10.1136/bcr-2022-254114
- language
- English
- LU publication?
- yes
- id
- 039e0a9c-5bff-49c8-984c-ae0f30b46835
- date added to LUP
- 2024-01-03 13:55:31
- date last changed
- 2024-04-18 11:17:10
@article{039e0a9c-5bff-49c8-984c-ae0f30b46835,
abstract = {{<p>We present a case of a woman in her 30s with relapsing-remitting multiple sclerosis, treated with natalizumab, who developed ophthalmic varicella zoster virus (VZV) infection, with subsequent vasculopathy causing cerebral ischaemic lesions. She was treated with acyclovir, prednisolone and acetylsalicylic acid and fully recovered. VZV vasculopathy is associated with stroke and immunomodulating treatments may increase the risks of these adverse events. To date, nine VZV-related vasculopathy cases in patients treated with natalizumab have been reported in English literature and are summarised in this paper. Although rare, VZV intracerebral vasculopathy is an important differential diagnosis in patients with unexplained new-onset neurological symptoms after a herpes zoster infection. Treatment guidelines for VZV vasculopathy and for continuing treatment of multiple sclerosis after such an event are currently not established.</p>}},
author = {{Elmståhl, Anna and Buchwald, Fredrik and Ilinca, Andreea}},
issn = {{1757-790X}},
keywords = {{Drugs: CNS (not psychiatric); Headache (including migraines); Infection (neurology); Multiple sclerosis; Stroke}},
language = {{eng}},
number = {{12}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Case Reports}},
title = {{Varicella-zoster virus vasculopathy in a patient with multiple sclerosis receiving natalizumab}},
url = {{http://dx.doi.org/10.1136/bcr-2022-254114}},
doi = {{10.1136/bcr-2022-254114}},
volume = {{16}},
year = {{2023}},
}