AlShammari Razan Z, AlOqayli Fatimah A, Alnafeesy Saleh K, Al Thubaiti Ibtisam
Department of Family Medicine, Armed Forces Hospitals, Dhahran, SAU.
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Cureus. 2023 Dec 31;15(12):e51412. doi: 10.7759/cureus.51412. eCollection 2023 Dec.
Herpes zoster (HZ) infection results from the reactivation of the varicella-zoster virus (VZV), which remains dormant in the dorsal root ganglia after an initial chickenpox infection. Although HZ appears more common in people with multiple sclerosis (MS) than expected in the general population, few studies have investigated this association, particularly with a normal absolute lymphocyte count (ALC). Additionally, no reported cases have discussed the clinical presentation of such patients. This report describes the case of a 26-year-old female with a known history of relapsing-remitting MS on dimethyl fumarate (DMF) treatment. She presented with a history of painful erythematous blisters, diagnosed as acute HZ infection with a normal ALC. This case provides evidence that warrants further research and attention to the management of patients with MS receiving DMF, particularly regarding infectious risks. It highlights the importance of pharmacovigilance and the potential benefits of VZV and HZ immunization in DMF recipients.
带状疱疹（HZ）感染是由水痘-带状疱疹病毒（VZV）重新激活引起的，该病毒在初次水痘感染后潜伏于背根神经节。虽然HZ在多发性硬化症（MS）患者中似乎比普通人群中预期的更为常见，但很少有研究调查这种关联，尤其是在绝对淋巴细胞计数（ALC）正常的情况下。此外，尚无报道病例讨论此类患者的临床表现。本报告描述了一名26岁女性病例，该患者有复发缓解型MS病史，正在接受富马酸二甲酯（DMF）治疗。她出现了疼痛性红斑水疱病史，诊断为急性HZ感染且ALC正常。该病例提供了证据，表明有必要进一步研究并关注接受DMF治疗的MS患者的管理，特别是关于感染风险。它强调了药物警戒的重要性以及VZV和HZ免疫接种对DMF接受者的潜在益处。
