Solano Quintin, Uttal Sarah, Higgins Peter D R, Berinstein Jeffrey A
Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA.
Department of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, Michigan, USA.
Case Rep Gastrointest Med. 2025 Jan 20;2025:6088333. doi: 10.1155/crgm/6088333. eCollection 2025.
Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.
用于治疗炎症性肠病的新型疗法会增加患者病毒再激活的风险。我们报告一例难治性克罗恩病（CD）患者的病例，该患者在医院接受高剂量皮质类固醇、肿瘤坏死因子抑制剂（TNFi）和 Janus 激酶抑制剂（JAKi）联合免疫抑制治疗后，出现了疫苗病毒株引起的原发性水痘（水痘）。虽然该患者康复且未出现长期不良反应，但她的病例提供了改进的机会。为提高安全性，医疗机构应制定方案，利用增强了临床决策支持系统的电子病历，识别并保护免疫功能低下的患者避免不适当的活疫苗接种。
