Herpes zoster laryngitis in a patient treated with fingolimod

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• 作者：Hideharu Hagiya^a ; ^{highgear@hp-infect.med.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Hisao Yoshida^a ; ^{falco60v@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Mikito Shimizu^b ; ^{u168970j@ecs.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Daisuke Motooka^c ; ^{daisukem@gen-info.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Shota Nakamura^c ; ^{nshota@gen-info.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Tetsuya Iida^c ; ^d ; ^{iida@biken.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Norihisa Yamamoto^a ; ^{norihisa65@hp-infect.med.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yukihiro Akeda^a ; ^{akeda@biken.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazunori Tomono^a ; ^{tomono@hp-infect.med.osaka-u.ac.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Fingolimod ; Herpes zoster virus ; Laryngopharyngitis ; Metagenomic analysis ; Next-generation sequencing technology
• 刊名：Journal of Infection and Chemotherapy
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：22
• 期：12
• 页码：830-832
• 全文大小：400 K

文摘

Development of treatment with immunomodulatory agents has improved prognosis of various autoimmune-related diseases. A sphingosin-1-phosphate receptor modulator, or fingolimod, is the first licensed oral drug for relapsing-remitting multiple sclerosis. The agent reduces circulating lymphocytes by trapping T cells in lymph nodes, possibly leading to reactivation of latent viruses. A 41-year-old Japanese woman who had been treated with fingolimod for 2 years presented with unilateral sore throat. Laryngoscopy revealed exudates unilaterally emerging on the left side of her supraglottic region. Serum level of the varicella zoster virus (VZV)-specific IgG was markedly elevated, and a result of genome sequence using the exudates demonstrated VZV as a possible causative pathogen. Fingolimod therapy was discontinued and the patient was successfully treated with intravenous acyclovir. This is the first reported case of fingolimod-associated herpes zoster laryngitis, in which the local VZV reactivation was demonstrated by next-generation sequencing technology. The present case highlights that the occurrence of VZV reactivation should be recalled in any patients undergoing fingolimod therapy.