一名正在使用乌帕替尼治疗的克罗恩病患者，已完成重组带状疱疹疫苗接种程序，却发生了严重播散性带状疱疹。
A Severe Case of Disseminated Herpes Zoster in a Patient With Crohn's Disease on Upadacitinib Who Completed the Recombinant Zoster Vaccine Series.
作者信息
Lue Nicole, Burdine Lauren, Kahan Tamara, Reddy Kirthan, Nelson Ryan, Lopez Corina, Lee Matthew, Wolf Jacqueline
机构信息
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA.
出版信息
ACG Case Rep J. 2025 Jan 29;12(2):e01599. doi: 10.14309/crj.0000000000001599. eCollection 2025 Feb.
Herpes zoster (HZ) is caused by the reactivation of the varicella zoster virus and presents with painful vesicular lesions in a dermatomal distribution. Disseminated HZ occurs when skin lesions erupt in numerous dermatomes. Upadacitinib is the first oral medication approved to treat moderate-severe Crohn's disease and has been associated with nonsevere cases of HZ. We present a case of a 60-year-old woman with refractory Crohn's disease who failed multiple immunosuppressive therapies, completed the recombinant zoster vaccines, and developed disseminated HZ on high-dose upadacitinib. She was treated with intravenous acyclovir, upadacitinib was discontinued, and was discharged on suppressive valacyclovir.
带状疱疹（HZ）由水痘-带状疱疹病毒再激活引起，表现为沿皮节分布的疼痛性水疱性皮损。当皮肤损害在多个皮节出现时，即为播散性HZ。乌帕替尼是首个被批准用于治疗中度至重度克罗恩病的口服药物，且与非重度HZ病例有关。我们报告一例60岁患有难治性克罗恩病的女性病例，该患者多种免疫抑制治疗均失败，接种了重组带状疱疹疫苗，并在服用高剂量乌帕替尼时发生了播散性HZ。她接受了静脉注射阿昔洛韦治疗，停用了乌帕替尼，并在出院时服用抑制性伐昔洛韦。
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