- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Young MS patients on Dimethyl Fumarate develop Aggressive Herpes Zoster: Case Study
Researchers have reported first young, not immunodeficient patients with normal Absolute Lymphocytic count to manifest severe Herpes zoster while on Dimethyl Fumarate, without any new CNS-clinical signs to warrant CSF examination.
There is a need for lymphocyte subset analysis to monitor the safety of young patients under Dimethyl Fumarate for Aggressive Herpes Zoster, according to a case study published in the Neurology journal.
Herpes zoster infection, commonly called shingles, is a viral infection caused due to the reactivation of the varicella-zoster virus. The varicella-zoster virus is also referred to as herpes zoster and is a member of the human herpesvirus family. Recent studies have suggested that a decrease in T-cells do not increase vulnerability for serious infections, hence lymphocyte subset analysis is not required for safety vigilance of patients under Dimethyl Fumarate therapy.
A study was conducted by Anagnostouli M, to demonstrate the importance of T-cell immunophenotyping in Herpes Zoster infection in young patients.
The researchers conducted a case study on two 2 young patients with relapsing-remitting multiple sclerosis, under Dimethyl Fumarate therapy. Both the patients were tested negative for HIV and SARS-CoV-2. They both had developed severe herpes zoster (HZ) infection with normal ALC but low CD8+ and high CD56bright natural killer (NK) cells.
The researchers found that in both the patients, extensive Herpes zoster infection was indicated based on the study of their T-cell immunophenotyping at the onset and low CD8+ T cells and increased CD56bright NK cells, after.
The researchers linked this high number of CD56bright NK cells noted in both the patients at the onset of skin rash to the aggressive lesions unusual for young non-immunosuppressed patients, requiring 6 weeks of antiviral therapy before resolution of skin lesions began.
Thus, the researchers concluded that the T-cell subset monitoring may still be significant during Dimethyl Fumarate therapy and that the combination of low CD8/high NK requires more scrutiny.
Although rare, the cases raise the question of pharmacovigilance and consideration for VZV vaccination in certain DMF-receiving patients.
Reference:
Aggressive Herpes Zoster in Young Patients with Multiple Sclerosis Under Dimethyl Fumarate: Significance of CD8+ and Natural Killer Cells by Anagnostouli M published in the Neurology journal.
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751