Abstract
We describe 2 allogeneic stem cell transplantation patients who developed chronic graft-versus-host disease (GVHD) after dermatomal varicella-zoster virus (VZV) infection. Localized zoster did not respond to oral valaciclovir but did resolve with intravenous aciclovir. However, skin eruptions, eye/oral dryness, and liver dysfunction were observed at the healing stage of localized zoster, suggesting development of GVHD. Intensification of immunosuppressive therapy was required to control GVHD. Quantitative real-time PCR for VZV DNA was used to distinguish liver involvement by chronic GVHD from visceral dissemination of VZV in 1 patient. VZV infection may trigger chronic GVHD after allogeneic stem cell transplantation.
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References
Arvin AM. Varicella-zoster virus infections. In: Thomas ED, Blume KG, Forman SJ, eds.Hematopoietic Stem Cell Transplantation. Malden, MA: Blackwell Science; 1999:591–606.
Steer CB, Szer J, Sasadeusz J, et al. Varicella-zoster infection after allogeneic bone marrow transplantation: incidence, risk factors and prevention with low-dose acyclovir and ganciclovir.Bone Marrow Transplant. 2000;25:657–664.
Atkinson K, Meyers JD, Storb R, et al. Varicella-zoster virus infection after marrow transplantation for aplastic anemia or leukemia.Transplantation. 1980;29:47–50.
Han CS, Miller W, Haake R, Weisdorf D. Varicella zoster infection after bone marrow transplantation: incidence, risk factors and complications.Bone Marrow Transplant. 1994;13:277–283.
Appleton AL, Sviland L. Pathogenesis of GVHD: role of herpes viruses.Bone Marrow Transplant. 1993;11:349–355.
Baselga E, Drolet BA, Segura AD, et al. Dermatomal lichenoid chronic graft-vs-host disease following varicella-zoster infection despite absence of viral genome.J Cutan Pathol. 1996;23:576–581.
Lacour JP, Sirvent N, Monpoux F, et al. Dermatomal chronic cutaneous graft-versus-host disease at the site of prior herpes zoster.Br J Dermatol. 1999;141:587–589.
Ratanatharathorn V, Ayash L, Lazarus HM, et al. Chronic graftversus-host disease: clinical manifestation and therapy.Bone Marrow Transplant. 2001;28:121–129.
Via CS, Shanley JD,Weatherly R, et al. Altered threshold for the induction of graft-versus-host immunodeficiency following murine cytomegalovirus infection: host and donor contributions.Transplantation. 1988;46:298–302.
Bostrom L, Ringden O, Jacobsen N, et al. A European multicenter study of chronic graft-versus-host disease: the role of cytomegalovirus serology in recipients and donors-acute graft-versus-host disease, and splenectomy.Transplantation. 1990;49:1100–1105.
Kimura H, Kido S, Ozaki T, et al. Comparison of quantitations of viral load in varicella and zoster.J Clin Microbiol. 2000;38:2447–2449.
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Kawano, N., Gondo, H., Kamimura, T. et al. Chronic Graft-versus-Host Disease following Varicella-Zoster Virus Infection in Allogeneic Stem Cell Transplant Recipients. Int J Hematol 78, 370–373 (2003). https://doi.org/10.1007/BF02983564
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DOI: https://doi.org/10.1007/BF02983564