International Journal of Hematology

, Volume 96, Issue 4, pp 516–520

Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy

Authors

    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Akihiro Abe
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Masataka Okamoto
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Tsukane Kobayashi
    • Department of DermatologyFujita Health University School of Medicine
  • Tomohiko Terazawa
    • Department of PharmacyFujita Health University School of Medicine
  • Yoko Inaguma
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Masutaka Tokuda
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Masamitsu Yanada
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Satoko Morishima
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Tadaharu Kanie
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Yukiya Yamamoto
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Motohiro Tsuzuki
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Yoshiki Akatsuka
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Shuichi Mizuta
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
  • Tetsushi Yoshikawa
    • Department of PediatricsFujita Health University School of Medicine
  • Nobuhiko Emi
    • Department of Hematology and Medical OncologyFujita Health University School of Medicine
Case Report

DOI: 10.1007/s12185-012-1160-4

Cite this article as:
Okamoto, A., Abe, A., Okamoto, M. et al. Int J Hematol (2012) 96: 516. doi:10.1007/s12185-012-1160-4

Abstract

Severe disseminated varicella zoster virus (VZV) infection rarely occurs in patients who are not recipients of hematopoietic stem cell transplantation. This report concerns severe disseminated VZV infection in a diffuse large B cell lymphoma (DLBCL) patient treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was an 82-year-old male with DLBCL who had a history of type II diabetes mellitus. He incurred VZV infection with severe hepatitis and disseminated intravascular coagulopathy after three courses of R-CHOP. When the VZV infection occurred, anti-VZV IgG was not detected and lymphopenia was observed. We initiated treatment with acyclovir, immunoglobulin, and thrombomodulin alpha, and rescued this patient. We suggest that the use of chemotherapy for immune-suppressed elderly lymphoma patients may involve the risk of severe VZV infection.

Keywords

Varicella zoster virusRituximabHepatitisDisseminated intravascular coagulopathy

Copyright information

© The Japanese Society of Hematology 2012