Mouzas I A, Greenstein A J, Giannadaki E, Balasubramanian S, Manousos O N, Sachar D B
Department of Gastroenterology, University Hospital, Heraklion, Greece.
Am J Gastroenterol. 1997 Sep;92(9):1534-7.
To study the natural history and outcome of varicella infection developing in steroid treated inflammatory bowel disease.
Varicella infection occurring in immunosuppressed or immunocompromised patients is a common problem with a significant mortality. Varicella infection during the course of inflammatory bowel disease has been reported in a small number of patients with at least one fatality.
Four young patients with inflammatory bowel disease who developed varicella infection while on immunosuppressive therapy, steroids, or azathioprine were studied. In each patient the infection was severe, and the three most recently treated patients received acyclovir.
All four patients developed severe varicella infection while receiving immunosuppressive therapy for their disease. Three patients were treated with intravenous acyclovir with concomitant reduction of steroid dosage and recovered completely. One patient, treated in 1980 with antibiotics and reduction in steroids, did not receive acyclovir and also survived.
Varicella infection is a relatively uncommon occurrence in inflammatory bowel disease. If varicella infection occurs, prompt diagnosis and treatment with acyclovir and concomitant reduction in immunosuppressive therapy (reduction in steroid dosage and discontinuation of azathioprine) should be initiated immediately to limit viremia and avoid fatal complications.
研究在接受类固醇治疗的炎症性肠病患者中发生的水痘感染的自然病史及转归。
免疫抑制或免疫功能低下患者发生的水痘感染是一个常见问题，死亡率较高。少数炎症性肠病患者在病程中发生了水痘感染，至少有1例死亡报告。
对4例在接受免疫抑制治疗、类固醇或硫唑嘌呤治疗期间发生水痘感染的年轻炎症性肠病患者进行了研究。每例患者的感染都很严重，最近3例接受治疗的患者使用了阿昔洛韦。
所有4例患者在接受疾病免疫抑制治疗期间均发生了严重的水痘感染。3例患者接受了静脉注射阿昔洛韦治疗，同时减少了类固醇剂量，最终完全康复。1例于1980年接受抗生素治疗并减少类固醇剂量的患者未使用阿昔洛韦，也存活了下来。
水痘感染在炎症性肠病中相对少见。如果发生水痘感染，应立即进行快速诊断，使用阿昔洛韦治疗，并同时减少免疫抑制治疗（减少类固醇剂量并停用硫唑嘌呤），以限制病毒血症并避免致命并发症。
