Herpes zoster laryngitis in a patient treated with fingolimod

Hideharu Hagiya, Hisao Yoshida, Mikito Shimizu, Daisuke Motooka, Shota Nakamura, Tetsuya Iida, Norihisa Yamamoto, Yukihiro Akeda, Kazunori Tomono

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Development of treatment with immunomodulatory agents has improved prognosis of various autoimmune-related diseases. A sphingosin-1-phosphate receptor modulator, or fingolimod, is the first licensed oral drug for relapsing-remitting multiple sclerosis. The agent reduces circulating lymphocytes by trapping T cells in lymph nodes, possibly leading to reactivation of latent viruses. A 41-year-old Japanese woman who had been treated with fingolimod for 2 years presented with unilateral sore throat. Laryngoscopy revealed exudates unilaterally emerging on the left side of her supraglottic region. Serum level of the varicella zoster virus (VZV)-specific IgG was markedly elevated, and a result of genome sequence using the exudates demonstrated VZV as a possible causative pathogen. Fingolimod therapy was discontinued and the patient was successfully treated with intravenous acyclovir. This is the first reported case of fingolimod-associated herpes zoster laryngitis, in which the local VZV reactivation was demonstrated by next-generation sequencing technology. The present case highlights that the occurrence of VZV reactivation should be recalled in any patients undergoing fingolimod therapy.

Original languageEnglish
Pages (from-to)830-832
Number of pages3
JournalJournal of Infection and Chemotherapy
Volume22
Issue number12
DOIs
Publication statusPublished - Dec 1 2016
Externally publishedYes

Keywords

  • Fingolimod
  • Herpes zoster virus
  • Laryngopharyngitis
  • Metagenomic analysis
  • Next-generation sequencing technology

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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