Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis
Noriaki ItoTakeshi MasudaKakuhiro YamaguchiShinjiro SakamotoYasushi HorimasuTaku NakashimaShintaro MiyamotoHiroshi IwamotoKazunori FujitakaHironobu HamadaKazuaki ChayamaNoboru Hattori
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ジャーナル オープンアクセス

2022 年 61 巻 19 号 p. 2961-2965

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A 72-year-old woman with rheumatoid arthritis was treated with methotrexate (MTX) and iguratimod. Upon examination of a liver tumor, blisters due to varicella-zoster virus (VZV) infection were observed. Despite oral administration of valacyclovir, she developed varicella pneumonia and meningoencephalitis. A VZV antibody test revealed reinfection. The liver tumor shrank after discontinuance of MTX, and polymerase chain reaction revealed the reactivation of the Epstein-Barr virus (EBV). Therefore, we were unable to deny MTX-associated lymphoproliferative disorder (MTX-LPD). This is the first case of a complication of pneumonia and meningoencephalitis due to VZV reinfection and EBV reactivation.

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© 2022 by The Japanese Society of Internal Medicine
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