Varicella Zoster Virus in Inflammatory Bowel Disease Patients: What Every Gastroenterologist Should Know

Schreiner, Philipp; Mueller, Nicolas J.; Fehr, Jan; Maillard, Michel H.; Brand, Stephan; Michetti, Pierre; Schoepfer, Alain; Restellini, Sophie; Vulliemoz, Marianne; Vavricka, Stephan R.; Juillerat, Pascal; Rogler, Gerhard; Biedermann, Luc

doi:10.1093/ecco-jcc/jjaa132

Cited by 9 publications

(6 citation statements)

References 115 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Medications associated with a higher risk of HZ in these patients include corticosteroids, thiopurines, and tofacitinib. 18 As regards anti-TNF treatment, contradictory results have been found. In a multivariate analysis, anti-TNF monotherapy was found not an independent risk factor for HZ in IBD; however, the severity and flare-up of the disease have the strongest association with the development of HZ.…”

Section: Discussionmentioning

confidence: 99%

Recurrent papulonodular herpes zoster, with syringitis, folliculitis, and vasculitis as clues to the diagnosis

Fawzy,

El‐Enany,

Abdelraouf

et al. 2023

J Cutan Pathol

View full text Add to dashboard Cite

Herpes zoster (HZ) may have atypical clinical presentations, particularly in immunosuppressed patients. Nodular HZ is an extremely rare condition. We report the first case of recurrent papulonodular HZ in an adult patient with inflammatory bowel disease (IBD) receiving biologic treatment. More interestingly, there was no epidermal involvement on histopathological examination, but the involvement of the adnexa and blood vessels was a clue to the diagnosis in view of the clinical context. We wish to raise awareness of this rare manifestation of HZ for early diagnosis and proper treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Recurrent papulonodular herpes zoster, with syringitis, folliculitis, and vasculitis as clues to the diagnosis

Fawzy,

El‐Enany,

Abdelraouf

et al. 2023

J Cutan Pathol

View full text Add to dashboard Cite

show abstract

“…Corticosteroids, thiopurines, methotrexate, and anti-TNF in monotherapy or even more in combination, are recognized risk factors for varicella infection[ 159 , 160 ]. The literature describes 23 cases of varicella in IBD patients receiving immunosuppressants and the fatality rate is reported to be 22%[ 161 ]. Diagnosis is based on clinical signs (fever and typical vesicular lesions in different stages of development on the face, trunk, and extremities), or real-time PCR on samples taken from skin lesions in an immunocompromised host or in the evaluation of atypical lesions[ 162 ].…”

Section: Viral Diseasesmentioning

confidence: 99%

“…There are insufficient data to make recommendations regarding zoster vaccination in immunosuppressed patients, but initial evidence suggests good safety and immunogenic profile in this subgroup of patients[ 171 - 173 ]. Therefore, it seems to be an acceptable strategy, to propose recombinant vaccine in patients with uncontrolled severe disease activity, history of shingles, a scheduled therapy with tofacitinib, treated with azathioprine and aged > 40 years, and to all patients aged > 50 years[ 161 ].…”

Section: Viral Diseasesmentioning

confidence: 99%

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Craviotto¹,

Furfaro²,

Loy³

et al. 2021

WJG

View full text Add to dashboard Cite

Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.

show abstract

“…HZ is due to the reactivation of the latent VZV within the sensory ganglia. Patients with IBD are at higher risk of severe primary VZV infection and of HZ [51] . The incidence and severity of HZ increase with advancing age, particularly > 50 years [52] .…”

Section: Varicella/zostermentioning

confidence: 99%

Vaccinations in patients with inflammatory bowel disease

Macaluso

Liguori

Galli

2021

Digestive and Liver Disease

View full text Add to dashboard Cite

Treatment of inflammatory bowel disease (IBD) frequently requires administration of immunosuppressive therapies, which increases susceptibility to a number of infectious pathogens. However, many infections can be prevented by correct and appropriate utilization of vaccinations. While several guidelines have been published on vaccination schedules in patients with IBD, vaccination rates remain suboptimal and even lower than those in the general population. This is due to many factors including poor awareness of the importance of vaccines by gastroenterologists and general practitioners as well as potential prejudices of patients regarding the safety and benefits of vaccines. With the aim of increasing awareness about the key role of immunization in the management of patients with IBD, the present review examines the existing literature relating to the main vaccinations and their application in these patients. We also summarize current evidence in order to provide clinicians with an easy source of reference for the principal recommendations for prevention of infectious diseases in patients with IBD. In addition, the recommendations about traveling for IBD patients are briefly explored. Lastly, since it is important for gastroenterologists to be aware of recommendations on vaccination, we recommend implementing educational programs to ensure compliance with current guidelines.

show abstract

Varicella Zoster Virus in Inflammatory Bowel Disease Patients: What Every Gastroenterologist Should Know

Cited by 9 publications

References 115 publications

Recurrent papulonodular herpes zoster, with syringitis, folliculitis, and vasculitis as clues to the diagnosis

Recurrent papulonodular herpes zoster, with syringitis, folliculitis, and vasculitis as clues to the diagnosis

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Vaccinations in patients with inflammatory bowel disease

Contact Info

Product

Resources

About