Varicella zoster virus encephalitis during treatment with anti-tumor necrosis factor-alpha agent in a psoriatic arthritis patient.
The introduction of targeted immunotherapies has greatly improved the therapeutic options of several inflammatory diseases such as psoriatic arthritis. However treatment-related opportunistic infections and viral reactivations may still occur. We describe a case of varicella zoster virus (VZV) encephalitis due to the reactivation of latent VZV infection during a long therapy with the anti-tumor necrosis factor-alpha (TNF-alpha) drug Adalimumab. The low incidence of VZV encephalitis in patients treated with biological agents does not justify VZV serological screening in these subjects, but careful monitoring of the patients is recommended to recognize early signs and symptoms of herpes zoster to start prompt antiviral therapy to prevent associated complications.
Buccoliero
Giovanni
G
S.C. Malattie Infettive, Presidio Ospedaliero Centrale, Stabilimento San G. Moscati, AUSL TA, Italia. giovannibuccoliero@libero.it
Lonero
Gaetano
G
Romanelli
Chiara
C
Loperfido
Pietro
P
Resta
Francesco
F
D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy*; D020804:Encephalitis, Varicella Zoster / Q000209:etiology*; D005260:Female; D014645:Herpesvirus 3, Human / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D014775:Virus Activation / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab