Atypical generalized zoster with suspicious esophageal involvement and early relapse in an adult renal transplant recepient

Oh, Kwang Ho; Ahn, Chi Hyun; Kim, Y.S; Han, Junghee; Kim, S; Lee, J.S; Kim, E.C; Oh, Mi-Young; Jin-Ja, Chung

doi:10.1016/s0041-1345(02)02744-6

Cited by 11 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although occasionally seen in immunocompetent individuals [55–64], such unusual presentations constitute fewer than 1% of total cases, being particularly characteristic of iatrogenic immunosuppression in transplant recipients [65, 66] or cancer patients [67–71], or human immunodeficiency virus (HIV) infection, in which bilateral [72, 73], multidermatomal [74], disseminated [75], or recurrent [73, 76, 77] HZ are often the presenting symptom [72, 78–80]. …”

Section: Clinicopathologymentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

View full text Add to dashboard Cite

BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

show abstract

Section: Clinicopathologymentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Immunocompromised patients with HZ may develop disseminated skin lesions that can mimic primary varicella during periods of potent immunosuppression . SOT recipients are more likely to present atypically , may present with multi‐organ involvement and can rarely develop invasive complications with delayed or absent rash . In SOT recipients, who may develop a multitude of other infectious and noninfectious rashes, laboratory testing is even more important than in the normal host, as a diagnosis may be more difficult to establish on clinical grounds alone.…”

Section: Diagnosismentioning

confidence: 99%

Varicella Zoster Virus in Solid Organ Transplantation

Pergam

Limaye

2013

American Journal of Transplantation

View full text Add to dashboard Cite

“…Immunocompromised patients with HZ may develop disseminated skin lesions that can mimic primary varicella during periods of prominent immunosuppression (2,17). SOT recipients are more likely to present atypically (29,30), and can rarely develop invasive complications without skin lesions (30). In SOT recipients, who may develop a multitude of other infectious and noninfectious rashes, laboratory testing is even more important than in the normal host, as diagnosis may be more difficult to establish on clinical grounds alone.…”

Section: Diagnosismentioning

confidence: 99%

Varicella Zoster Virus (VZV) in Solid Organ Transplant Recipients

Pergam

Limaye

2009

American Journal of Transplantation

View full text Add to dashboard Cite

Epidemiology and Risk Factors Epidemiology Varicella zoster virus (VZV) is an exclusively human virus that belongs to the a-herpesvirus family. VZV is present worldwide and is highly infectious. Primary infection leads to acute varicella or 'chickenpox,' usually and disseminated intravascular coagulation (14-19). HZ is a frequent infectious complication in SOT recipients with an incidence of approximately 8-11% during the first 4 years posttransplant (20-22). Invasive disease and dissemination similar to that seen in primary VZV infection are uncommon but have been reported in SOT and other immunocompromised populations, and level of immunosuppression may alter the risk of developing these complications (17,23,24). Rates of PHN in SOT recipients may also be higher than in immunocompetent populations (22). Risk factors development of HZ (20,21). In similar studies, heart and lung transplant patients have increased rates of HZ compared to other transplant recipients, possibly related at least in part to more intensive immunosuppression (20,22). The use of mycophenolate mofetil (MMF) has also been suggested as a potential risk factor for the development of HZ (24,27). It is unknown whether the development of HZ prior to transplant will lessen posttransplant VZV reactivation. DiagnosisIn general, both primary varicella and HZ have typical clinical presentations that allow for a presumptive clinical S108

show abstract

Atypical generalized zoster with suspicious esophageal involvement and early relapse in an adult renal transplant recepient

Cited by 11 publications

References 13 publications

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Varicella Zoster Virus in Solid Organ Transplantation

Varicella Zoster Virus (VZV) in Solid Organ Transplant Recipients

Contact Info

Product

Resources

About