Acupuncture, Shingles, and Allergen Immunotherapy

Area of Science:

• Neurology
• Immunology
• Integrative Medicine

Background:

• Varicella-zoster virus (VZV) establishes latency in dorsal root ganglia.
• Reactivation can be incited by stress, trauma, illness, or immune decline.
• Previous reports link acupuncture to VZV reactivation and shingles.

Observation:

• A patient with a history of thyroid cancer and chronic neck pain underwent acupuncture.
• Following acupuncture and an allergy shot, she developed acute Herpes zoster (shingles).
• Treatment included acyclovir and topical Aloe vera, resulting in mild scarring without postherpetic neuralgia.

Findings:

• Acupuncture represents a minor trauma that can potentially predispose patients to VZV reactivation.
• Concurrent allergen immunotherapy may contribute to immune system activation, increasing shingles risk.
• This case suggests a possible association between acupuncture, immunotherapy, and shingles.

Implications:

• Clinicians should consider VZV reactivation risk in patients undergoing acupuncture, especially with concurrent immune challenges.
• Further research is warranted to elucidate the mechanisms linking acupuncture, immunotherapy, and VZV reactivation.
• Understanding these triggers can inform patient management and preventative strategies.