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Herpes zoster in systemic lupus erythematosus
S Manzi1, L H Kuller, J Kutzer
1Department of Medicine, Graduate School of Public Health, Pittsburgh, PA, USA.
The Journal of Rheumatology
|July 1, 1995
Summary
Systemic lupus erythematosus (SLE) patients on immunosuppressants like cyclophosphamide and azathioprine, with lupus nephritis or malignancy, face higher herpes zoster risk. However, herpes zoster in SLE patients typically has a benign course, often not requiring immunosuppression withdrawal.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Herpes zoster (shingles) is a viral infection that can occur in patients with systemic lupus erythematosus (SLE).
- Identifying risk factors for herpes zoster in SLE patients is crucial for management and prevention.
- Understanding the clinical course and sequelae of herpes zoster in this population is essential.
Purpose of the Study:
- To define the clinical spectrum and disease sequelae of herpes zoster in SLE patients.
- To determine risk factors associated with developing herpes zoster in SLE patients.
Main Methods:
- Retrospective matched case-control study of SLE patients.
- Cases: SLE patients with their first episode of zoster after lupus diagnosis.
- Controls: SLE patients without zoster, matched 2:1 for age, race, sex, and survival status.
Main Results:
- 15% of SLE patients developed herpes zoster.
- Risk factors included cyclophosphamide, azathioprine, lupus nephritis, and prior/concurrent malignancy.
- Herpes zoster in SLE patients generally had a benign course with rare complications like postherpetic neuralgia.
Conclusions:
- Immunosuppressive therapy, lupus nephritis, and malignancy are potential risk factors for herpes zoster in SLE.
- Herpes zoster in SLE patients is typically benign and may not necessitate discontinuing immunosuppressive therapy.
- Distinguishing patients needing intensive antiviral therapy or hospitalization from those with a self-limited course is important.
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