title: Ophthalmic manifestations of herpes zoster virus in patients with multiple myeloma following bone marrow transplantation.
abstract: We report three patients with ophthalmic herpes zoster (HZ) manifestations on the background diagnosis of multiple myeloma (MM). It seems that immunocompromised status has caused reactivation of the varicella zoster virus (VZV) producing a well-characterised neurological syndrome and subsequent postherpetic neuralgia in two patients. One patient experienced lymphocytic leptomeningitis resulting in unilateral optic neuritis. All patients received similar myeloma disease-specific treatment prior to HZ reactivation. All patients were treated with thalidomide and steroids, and they thereafter underwent autologous stem cell transplantation. Prior to HZ reactivation they received new immunomodulatory drugs in the form of thalidomide in addition to bortezomib (2 patients) and lenalidomide (1 patient). Immediate specific antiviral therapy was successfully applied with intravenous acyclovir for 10 days, followed by long-term oral famciclovir maintenance. Two patients progressed to have chronic HZ ophthalmicus and postherpetic neuralgia requiring ongoing antiviral therapy and neuroepileptic medications for the neuropathic pain.
authors: Department of Haematology, Launceston General Hospital, Launceston, Tasmania, Australia. Alhossain@yahoo.com
authors: Alhossain A
authors: AA
authors: Khalafallah
authors: Miriam
authors: M
authors: Woodgate
authors: Kurien
authors: K
authors: Koshy
authors: Andrew
authors: A
authors: Patrick
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D014645:Herpesvirus 3, Human / Q000235:genetics*; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000601:surgery*; D016133:Polymerase Chain Reaction
chemical_list: D004279:DNA, Viral