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©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2013; 19(21): 3347-3351
Published online Jun 7, 2013. doi: 10.3748/wjg.v19.i21.3347
Published online Jun 7, 2013. doi: 10.3748/wjg.v19.i21.3347
Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn’s disease
Christopher Ma, Brennan Walters, Richard N Fedorak, Division of Gastroenterology, University of Alberta, Edmonton, AL T6G 2X8, Canada
Author contributions: Ma C, Walters B and Fedorak RN contributed to the manuscript writing and revision of the manuscript.
Supported by Abbott Canada to Fedorak RN
Correspondence to: Richard N Fedorak, MD, FRCPC, Associate Vice President, Professor of Medicine, Division of Gastroenterology, University of Alberta, 2-14A Zeidler Building, Edmonton, AL T6G 2X8, Canada. richard.fedorak@ualberta.ca
Telephone: +1-780-4926941 Fax: +1-780-4928121
Received: January 3, 2013
Revised: March 21, 2013
Accepted: April 3, 2013
Published online: June 7, 2013
Revised: March 21, 2013
Accepted: April 3, 2013
Published online: June 7, 2013
Core Tip
Core tip: Opportunistic viral infections can complicate anti-tumor necrosis factor (TNF) therapy for inflammatory bowel disease (IBD). Central nervous system varicella zoster virus (VZV) infections associated with the use of anti-TNF therapy have not been previously described in Crohn’s disease patients. We present the first reported case of VZV meningitis in a 40-year-old male with Crohn’s disease who developed reactivation dermatomal herpes zoster and VZV meningitis after treatment with adalimumab and prednisone. Despite aggressive antiviral therapy, he had significant morbidity, highlighting the risk of opportunistic viral infections in this population and the importance of vaccination before anti-TNF therapy.