Herpes Zoster Meningitis Complicating Combined Tocilizumab and Cyclosporine Therapy for Adult-Onset Still's Disease.
A 56-year-old female with refractory adult-onset Still's disease presented with ocular herpes zoster infection during TCZ treatment. After three days of acyclovir treatment (5 mg/kg), she developed a severe headache and high fever. Viral DNA isolation and cerebral spinal fluid abnormalities led to a herpes zoster meningitis diagnosis. Her meningitis was cured by high doses of intravenous acyclovir (10 mg/kg for 14 days). To our knowledge, this is the first report of meningeal herpes zoster infection in rheumatic diseases under TCZ treatment.
Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Shinichiro
S
Tsurukawa
Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Nozomi
N
Iwanaga
Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Yasumori
Y
Izumi
Department of Pharmacy, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Atsunori
A
Shirakawa
Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Chieko
C
Kawahara
Department of Dermatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Tetsuo
T
Shukuwa
Department of Ophthalmology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Miwako
M
Inamoto
Department of Immunology and Rheumatology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
Atsushi
A
Kawakami
Department of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
Kiyoshi
K
Migita