Herpes Zoster in Patients with Polymyositis and Dermatomyositis

Nagaoka, Shohei; Tani, Kenji; Ishigatsubo, Yoshiaki; Chiba, Jun; Kato, Kiyoshi; Matsunaga, Keiichiro; Narita, Michiko; Igarashi, Toshihisa; Ōkubo, Takao

doi:10.11150/kansenshogakuzasshi1970.64.1394

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…In this study, opportunistic infections comprised over a third of all infections in which a causative microorganism was identified, with the most common being varicella zoster virus. Varicella zoster infections have been reported often in the context of high‐dose systemic steroid therapy but not as frequently as reported here in our series . Such findings raise the question as to whether patients with autoimmune neuromuscular disease should be vaccinated for varicella zoster or be started on prophylactic antiviral therapy.…”

Section: Discussionsupporting

confidence: 42%

Infections and the relationship to treatment in neuromuscular autoimmunity

et al. 2017

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Section: Discussionsupporting

confidence: 42%

Infections and the relationship to treatment in neuromuscular autoimmunity

et al. 2017

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“…48 Patients with polymyositis or dermatomyositis also have a higher incidence of herpes zoster (27.2 cases per 1,000 patient-years) than the general population. 36 …”

Section: Streptococcus Pneumoniaementioning

confidence: 97%

“…30 The risk of patients with SLE contracting herpes zoster is also increased (5-fold to 16-fold), compared with the general population. [31][32][33] In these patients, the incidence of herpes zoster ranges from 12.0-91.5 cases per 1,000 patient-years, [31][32][33][34][35][36][37][38] and the percentage of patients with SLE who develop herpes zoster ranges from 3.2% to 46.6%. 31,33,[36][37][38][39][40][41][42][43][44][45] The risk of herpes zoster infection is associated with the use of immuno suppressive drugs; 31,33-35 the risk is lower for mycophenolic acid than for cyclophosphamide (relative risk [RR] 0.36).…”

Section: Streptococcus Pneumoniaementioning

confidence: 99%

Vaccination of patients with autoimmune inflammatory rheumatic diseases

et al. 2014

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Patients with autoimmune inflammatory rheumatic diseases (AIRDs) are at increased risk of infections. This risk has been further increased by the introduction of biologic agents over the past two decades. One of the most effective strategies to prevent infection is vaccination. However, patients with an AIRD have a compromised immune system, which is further impaired by medication. Another important issue is the possibility of triggering a broad nonspecific response by vaccination, potentially resulting in increased activity of the underlying autoimmune disease. In this Review, we provide an analysis of data on vaccination of patients with an AIRD. Both the efficacy and the safety of vaccination are addressed, together with the epidemiology of vaccine-preventable infectious diseases in different subgroups of adults with AIRDs. Special attention is given to vaccination of patients who are treated with biologic agents.

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“…Through a few epidemiological studies, HZ in DM/PM has been investigated within the context of other opportunist infections or by examining a few myositis cases with HZ (13)(14)(15). Thus, Fardet et al (13) analyzed the incidence, risk factors, and severity of HZ in 121 patients with DM.…”

Section: And Introductionmentioning

confidence: 99%

Chloroquine diphosphate: a risk factor for herpes zoster in patients with dermatomyositis/polymyositis

Cunha¹,

Souza²,

Levy‐Neto³

et al. 2013

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OBJECTIVES:Herpes zoster has been widely described in the context of different systemic autoimmune diseases but not dermatomyositis/polymyositis. Therefore, we analyzed the prevalence, risk factors and herpes zoster outcomes in this population.METHOD:A retrospective cohort study of herpes zoster infections in dermatomyositis/polymyositis patients was performed. The patients were followed at a tertiary center from 1991 to 2012. For the control group, each patient with herpes zoster was paired with two patients without herpes zoster. Patients were matched by gender and the type of myositis, age at myositis onset and disease duration.RESULTS:Of 230 patients, 24 (10.4%) had a histories of herpes zoster (19 with dermatomyositis and five with polymyositis, two-thirds female). The mean age of the patients with herpes zoster was 44.6±16.8 years. No difference between the groups was found regarding cumulative clinical manifestations. Disease activity, autoantibody, muscle and leukogram parameters were also comparable between the groups. No differences in immunosuppressive (alone or in association with other immunosuppressive therapies) or glucocorticoid (current use, medium dose and cumulative dose in the last two months) therapies were found between patients with and without herpes zoster. However, a higher proportion of patients in the herpes zoster group received chloroquine diphosphate compared to the control group. All of the patients received acyclovir; 58.3% of patients had postherpetic neuralgia and no cases of recurrence were reported. Furthermore, individuals who were taking high prednisone doses at the time of the herpes zoster diagnosis had reduced levels of postherpetic neuralgia.CONCLUSIONS:These data suggest that chloroquine diphosphate could predispose patients with dermatomyositis/polymyositis to developing herpes zoster, particularly women and dermatomyositis patients.

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Herpes Zoster in Patients with Polymyositis and Dermatomyositis

Cited by 11 publications

References 9 publications

Infections and the relationship to treatment in neuromuscular autoimmunity

Infections and the relationship to treatment in neuromuscular autoimmunity

Vaccination of patients with autoimmune inflammatory rheumatic diseases

Chloroquine diphosphate: a risk factor for herpes zoster in patients with dermatomyositis/polymyositis

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