title: [A case of neuromyelitis optica with varicella zoster virus meningitis during mitoxantrone treatment].
abstract: A 36-year-old woman with neuromyelitis optica had been treated with steroids for the prevention of relapse. However, her treatment was not effective and she showed adverse effects such as diabetes mellitus, osteoporosis, compression fractures, and Pneumocystis carinii pneumonia. Therefore, we started her on mitoxantrone treatment. After five courses of mitoxantrone injection, she developed a herpes zoster infection in her thigh followed by aseptic meningitis. PCR for varicella zoster virus (VZV)-DNA was positive in the cerebrospinal fluid. The mechanisms that caused VZV reactivation by mitoxantrone are not known. Opportunistic herpes virus reactivation may occur easily with increasing use of immunosuppressive drugs for both neuromyelitis optica and multiple sclerosis. These drugs must be used under careful supervision.
authors.affiliation: Multiple Sclerosis Center, Utano National Hospital.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakano
authors.forename: Rie
authors.initials: R
authors.lastname: Motoyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masami
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D005260:Female; D006562:Herpes Zoster / Q000209:etiology*; D006801:Humans; D008587:Meningitis, Viral / Q000209:etiology*; D008942:Mitoxantrone / Q000009:adverse effects*; D009471:Neuromyelitis Optica / Q000150:complications / Q000188:drug therapy*; D014775:Virus Activation
chemical_list: D008942:Mitoxantrone