Chronic graft-versus-host disease following varicella-zoster virus infection in allogeneic stem cell transplant recipients.
We describe 2 allogeneic stem cell transplantation patients who developed chronic graft-versus-host disease (GVHD) after dermatomal varicella-zoster virus (VZV) infection. Localized zoster did not respond to oral valaciclovir but did resolve with intravenous aciclovir. However, skin eruptions, eye/oral dryness, and liver dysfunction were observed at the healing stage of localized zoster, suggesting development of GVHD. Intensification of immunosuppressive therapy was required to control GVHD. Quantitative real-time PCR for VZV DNA was used to distinguish liver involvement by chronic GVHD from visceral dissemination of VZV in 1 patient. VZV infection may trigger chronic GVHD after allogeneic stem cell transplantation.
Kawano
Noriaki
N
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. kawano@1nai.med.kyushu-u.ac.jp
Gondo
Hisashi
H
Kamimura
Tomohiko
T
Aoki
Kenichi
K
Iino
Tadafumi
T
Ishikawa
Fumihiko
F
Miyamoto
Toshihiro
T
Nagafuji
Koji
K
Shimoda
Kazuya
K
Hayashi
Shin
S
Otsuka
Teruhisa
T
Kazuyama
Yukumasa
Y
Harada
Mine
M
D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy; D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D014645:Herpesvirus 3, Human / Q000235:genetics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D004279:DNA, Viral; D007166:Immunosuppressive Agents