Three cases of herpes zoster radiculitis in MS patients treated with natalizumab

Bassem I Yamout1, Nuhad Abou Zeid1, Ali J Taha1

  • 1Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.

Insights

Natalizumab, a multiple sclerosis treatment, has been linked to rare herpes zoster infections in patients. Clinicians should monitor for these opportunistic infections during treatment.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Natalizumab is an FDA-approved monoclonal antibody therapy for multiple sclerosis (MS).
  • While effective, natalizumab treatment carries risks of opportunistic infections, including progressive multifocal leukoencephalopathy (PML).

Observation:

  • Three cases of herpes zoster infections were observed in patients receiving natalizumab for MS.
  • Herpes zoster is a rare but serious opportunistic infection reported in patients on natalizumab therapy.

Findings:

  • The study highlights herpes zoster as a potential opportunistic infection associated with natalizumab treatment in multiple sclerosis patients.
  • These findings suggest a need for increased vigilance regarding infections during natalizumab therapy.

Implications:

  • Clinicians treating multiple sclerosis patients with natalizumab require heightened awareness of herpes zoster risks.
  • Early detection and management of opportunistic infections like herpes zoster are crucial for patient safety during natalizumab therapy.

Related Concept Videos

Herpes01:28

Herpes

Herpes simplex type 1 (HSV‑1) is a widespread pathogen responsible for orolabial lesions. It is an enveloped, double-stranded DNA (dsDNA) virus belonging to the family Herpesviridae. Once the virus infects a host cell, its double‑stranded DNA genome is delivered into the nucleus, where a coordinated cascade of immediate‑early, early, and late gene expression directs viral DNA replication, structural protein synthesis, and virion assembly. After primary infection of epithelial cells, HSV-1...
Chickenpox01:20

Chickenpox

Chickenpox is an acute, highly contagious disease caused by the varicella-zoster virus (VZV), a double-stranded DNA virus belonging to the Herpesviridae family. Its transmission occurs primarily through the inhalation of respiratory droplets or direct contact with vesicular fluid from skin lesions. The incubation period typically ranges from 10 to 21 days, during which the virus replicates and disseminates through sequential phases within the host. Although generally self-limiting in children,...
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Genital Herpes01:23

Genital Herpes

Genital herpes is a sexually transmitted infection primarily caused by herpes simplex virus type 2 (HSV-2), though herpes simplex virus type 1 (HSV-1) is increasingly implicated in genital infections, particularly among younger populations. Transmission occurs mainly through sexual contact, with asymptomatic viral shedding serving as a major route of spread. This characteristic makes HSV-2 difficult to control at a population level, as individuals may unknowingly transmit the virus even in the...
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...