title: Case reports: zoster pain in haematological malignancies: effective pain relief with oxycodone in patients unresponsive to other analgesic measures.
abstract: Varicella zoster virus (VZV) outbreak is a significant cause of morbidity in patients suffering from blood-related malignancies, occurring mostly among those affected by lymphoproliferative disorders and in those receiving haematopoietic stem-cell transplantation. The elucidated pathological mechanisms of VZV-related painful complications have provided the rationale for acute zoster pain (AZP) and post-herpetic neuralgia (PHN) treatment with antiviral therapy combined with neuroactive agents, such as tricyclic or anticonvulsant agents. The role of opioids in this setting is less clearly established. We successfully treated (with oxycodone) 12 consecutive patients suffering from AZP and long-lasting PHN resistant to several agents, including anticonvulsants and analgesics. Our experience is reported together with a brief overview of the management of these often distressing and intractable complications.
authors.affiliation: Haematology Division, Sant'Eugenio Hospital, Tor Vergata University, Rome, Italy. pasquale.niscola@uniroma2.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Niscola
authors.forename: Alessio Pio
authors.initials: AP
authors.lastname: Perrotti
authors.forename: Giovanni
authors.initials: G
authors.lastname: del Poeta
authors.forename: Claudio
authors.initials: C
authors.lastname: Romani
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Palombi
authors.forename: Daniela
authors.initials: D
authors.lastname: Piccioni
authors.forename: Laura
authors.initials: L
authors.lastname: Scaramucci
authors.forename: Barbara
authors.initials: B
authors.lastname: Tolu
authors.forename: Andrea
authors.initials: A
authors.lastname: Tendas
authors.forename: Luca
authors.initials: L
authors.lastname: Cupelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Abruzzese
authors.forename: Gianna Maria
authors.initials: GM
authors.lastname: D'Elia
authors.forename: Gregorio Antonio
authors.initials: GA
authors.lastname: Brunetti
authors.forename: Luca
authors.initials: L
authors.lastname: Maurillo
authors.forename: Marco
authors.initials: M
authors.lastname: Giovannini
authors.forename: Claudio
authors.initials: C
authors.lastname: Cartoni
authors.forename: Paolo
authors.initials: P
authors.lastname: de Fabritiis
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000588:Amines / Q000008:administration & dosage / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D019337:Hematologic Neoplasms / Q000150:complications*; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000998:Antiviral Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D010098:Oxycodone