Visceral disseminated varicella zoster virus infection during non-intensive maintenance therapy in a patient with systemic lupus erythematosus

Mod Rheumatol Case Rep. 2023 Jan 3;7(1):57-59. doi: 10.1093/mrcr/rxac054.

Abstract

Visceral disseminated varicella zoster virus infection (VD-VZV) is a rare complication in immunocompromised patients. Although systemic lupus erythematosus (SLE) patients have a higher risk of VZV infection, only a few reports describe VD-VZV in SLE. Here, we report a 48-year-old woman with SLE who had received maintenance therapy. She was transferred to the hospital because of severe epigastric pain. There were no significant abnormalities in abdominal computed tomography and upper gastrointestinal endoscopy. On hospital day 4, she developed vesicular eruption on her face and abdomen. VZV antigen was detected in specimens obtained from skin lesions, and treatment with acyclovir was started. VZV DNA in blood turned out to be positive, and the epigastric pain was thought to be caused by VD-VZV. There is a risk of VD-VZV in patients with SLE, even in those receiving non-intensive maintenance therapy.

Keywords: Systemic lupus erythematosus; immunocompromised host; varicella zoster virus.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Herpes Zoster* / complications
  • Herpes Zoster* / diagnosis
  • Herpes Zoster* / drug therapy
  • Herpesvirus 3, Human / genetics
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / diagnosis
  • Lupus Erythematosus, Systemic* / drug therapy
  • Middle Aged
  • Pain / complications
  • Varicella Zoster Virus Infection* / complications
  • Varicella Zoster Virus Infection* / diagnosis
  • Varicella Zoster Virus Infection* / drug therapy