Two multiple sclerosis cases developed herpes zoster during use of fingolimod

Multiple sclerosis (MS) is an inflammatory, demyelinating disease of the central nervous system. Immunosuppressive and immunomodulating drugs are used during disease monitoring. Fingolimod is one of the immunomodulatory treat- ments used in MS patients. It is a therapeutic agent acting on lymphocytes. La- tent varicella-zoster virus infections may occur in MS patients receiving fingo- limod therapy. In this article, the information of two cases with varicella-zoster virus reactivation during fingolimod use were presented.

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  • Ahmed, A.M., Brantley, J.S., Madkan, V., Mendoza, N., Tyring, S.K., 2007. Managing herpes zoster in immunocompromised patients. Herpes. 14, 32-6.
  • Bennett, G.J., 1994. Hypotheses on the pathogenesis of herpes zoster associated pain. Ann Neurol. 35, 38-41.
  • Brody, M.B., Moyer, D., 1997. Varicella-zoster virus infection. Postgrad Med. 102(1), 187–94.
  • Cohen, J.I., Brunell, P.A., Straus, S.E., Krause, P.R., 1999. Recent advances in varicella-zoster virus infection. Ann Intern Med.130, 922-32.
  • Cohen, J.A., Barkhof, F., Comi, G., Hartung, H.P., Khatri, B.O., Montalban, X., Pelletier, J., Capra, R., Gallo, P., Izquierdo, G., Tiel-Wilck, K., de Vera, A., Jin, J., Stites, T., Wu, S., Aradhye, S., Kappos, L., Transforms Study Group., 2010. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 362, 402-15.
  • Dworkin, R.H., Johnson, R.W., Breuer, J., Gnann, J.W., Levin, M.J., Backonja, M., Betts, R.F., Gershon, A.A., Haanpaa, M.L., McKendrick, M.W., Nurmikko, T.J., Oaklander, A.L., Oxman, M.N., Pavan-Langston, D., Petersen, K.L., Rowbotham, M.C., Schmader, K.E., Stacey, B.R., Tyring, S.K., van Wijck, A.J., Wallace, M.S., Wassilew, S.W., Whitley, R.J., 2007. Recommendations for the management of herpes zoster. Clin Infect Dis. 44(1), 1-26.
  • Gnann, J.W. Jr., Whitley, R.J., 2002. Clinical practice: herpes zoster. N Engl J Med. 347, 340-6. Kappos, L., Radue, E.W., O’Connor, P., Polman, C., Hohlfeld, R., Calabresi, P., Selmaj, K., Agoropoulou, C., Leyk, M., Zhang- Auberson, L., Burtin, P., Freedoms Study Group., 2010. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med. 362, 387-401.
  • Ricklin, M.E., Lorscheider, J., Waschbisch, A., Paroz, C., Mehta, S.K., Pierson, D.L., Kuhle, J., Fischer-Barnicol, B., Sprenger, T., Lindberg, R.L., Kappos, L., Derfuss, T., 2013. T-cell response against varicella-zoster virus in fingolimod-treated MS patients. Neurology. 9, 81(2), 174-81.
  • Strauss, S.E., 1994. Overview: the biology of varicella-zoster virus infection. Ann Neurol. 35, 4–8.
  • Uccelli, A., Ginocchio, F., Mancardi, G.L., Bassetti, M., 2011. Primary varicella zoster infection associated with fingolimod treatment.Neurology. 15, 76(11), 1023-4.
  • Weinberg, J.M., 2007. Herpes zoster: epidemiology, natural history, and common complications. J Am Acad Dermatol. 57, 130-5. Winkelmann, A., Löbermann, M., Reisinger, E.C., Zettl, U.K. 2012. Fingolimod treatment for multiple sclerosis patients. Infectiological aspects and recommendations for vaccinations. Nervenarzt. 83(2), 236-42.