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1.
J Oncol Pharm Pract ; 28(7): 1659-1663, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35119328

RESUMO

INTRODUCTION: Bortezomib is proteasome inhibitor used in multiple myeloma treatment. The reactivation of herpes simplex virus (HSV) and varicella-zoster virus (VZV) during bortezomib-based therapy is a well-known adverse event. Antiviral prophylaxis is mandatory. Nevertheless, reports of herpesviral encephalitis are scarce. CASE REPORT: A 57-year-old multiple myeloma patient who during CyBorD protocol (Bortezomib, cyclophosphamide, and dexamethasone), after a transient suspension of antiviral prophylaxis presented progressive headaches unresponsive to conventional analgesics, asthenia, fever, episodic visual hallucinations, and vesicular lesions in the right supraorbital and frontal region. Herpetic encephalitis was diagnosed after detecting herpes zoster in cerebrospinal fluid. MANAGEMENT & OUTCOME: The patient was treated with acyclovir 500mg every 6 hours for 21 days, and subsequent valacyclovir prophylaxis achieving an excellent clinical evolution. Anti-myeloma treatment was changed to lenalidomide and dexamethasone achieving a durable complete response. Herpesviral encephalitis is a rare but severe complication associated with the use of Bortezomib, especially when patients did not receive acyclovir prophylaxis. However, a rapid detection based on the clinical suspicion, and the prompt start of treatment, may lead to overcome this adverse event.


Assuntos
Amiloidose , Antineoplásicos , Encefalite por Herpes Simples , Mieloma Múltiplo , Aciclovir/efeitos adversos , Amiloidose/induzido quimicamente , Amiloidose/complicações , Amiloidose/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antivirais/efeitos adversos , Ácidos Borônicos/efeitos adversos , Bortezomib/efeitos adversos , Dexametasona/efeitos adversos , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/tratamento farmacológico , Herpesvirus Humano 3/fisiologia , Humanos , Pessoa de Meia-Idade , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Pirazinas
3.
Brain Dev ; 43(10): 1057-1060, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34243963

RESUMO

Herpes simplex encephalitis is the most common cause of sporadic fatal encephalitis. More than half of patients with herpes simplex encephalitis will die and the vast majority of survivors have severe neurologic sequelae without effective antiviral therapy. Some people experience relapses such as secondary anti-N-methyl-d-aspartate receptor encephalitis despite appropriate antiviral treatment. It is rare that virus reactivation after immunotherapy of anti-N-methyl-d-aspartate receptor encephalitis after herpes simplex encephalitis. In the present study, we retrospectively review one patient who showed this rare situation.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico , Encefalite Antirreceptor de N-Metil-D-Aspartato/etiologia , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/complicações , Fatores Imunológicos/efeitos adversos , Criança , Humanos
4.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413050

RESUMO

Herpes simplex virus (HSV) encephalitis affects 2-4 people per million/year. Immunocompomised patients can have atypical presentations of HSV encephalitis, including a lack of cerebrospinal fluid (CSF) pleocytosis. We present the case of a patient who was receiving ustekinumab therapy for psoriasis which inhibits interleukin (IL)-12 and IL-23 signalling pathways. The initial presentation was suggestive of encephalitis, but he was discharged prior to the reporting of HSV positivity due to the lack of CSF pleocytosis. On representation, he had worsening symptoms and imaging showed midline shift, indicating cerebral oedema despite the immunosupressant effects of ustekinumab. He required intensive care unit support and treatment with high dose aciclovir and dexamethasone; after a month of treatment he made a good recovery. This case is the first to report a link between ustekinumab and HSV encephalitis, and also emphasises that imunocompromised patients can lack CSF pleocytosis and develop significant cerebral oedema which responds to immune suppression.


Assuntos
Anti-Inflamatórios/uso terapêutico , Edema Encefálico/diagnóstico , Fármacos Dermatológicos/efeitos adversos , Encefalite por Herpes Simples/diagnóstico , Hospedeiro Imunocomprometido , Ustekinumab/efeitos adversos , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Adulto , Anti-Inflamatórios/administração & dosagem , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Edema Encefálico/induzido quimicamente , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/tratamento farmacológico , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Diagnóstico Diferencial , Encefalite por Herpes Simples/líquido cefalorraquidiano , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/tratamento farmacológico , Humanos , Masculino , Psoríase/tratamento farmacológico
5.
J Biol Regul Homeost Agents ; 31(3): 679-682, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28956417

RESUMO

Herpes simplex encephalitis (HSE) is associated with significant mortality and morbidity. As a consequence of HSE, up to 75% of infected individuals die or experience irreversible neurological damage. While the pathogenesis of the disease is unknown, it is traditionally hypothesized that the viral infection occurs by neuronal transmission directly from peripheral sites. Non-neuronal modes of infection have generally been overlooked as the brain is protected by the blood-brain-barrier (BBB). The BBB poses an effective barrier to pathogens as well as to drugs such as chemotherapies. In the pursuit to deliver chemotherapeutic agents to the brain, several studies demonstrated that phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, may increase the permeability of the BBB enabling successful delivery of chemotherapeutic agents to the brain. In this communication, we report a case of HSE infection in a 62-year-old man, which we suspect was facilitated by the use of sildenafil during a primary genital herpes simple virus (HSV) infection. Due to large number of patients treated with PDE5 inhibitors for erectile dysfunction and the high incidence of genital HSV infection in the general population, a larger study should examine the potential risk of developing HSE in patients treated with PDE5 inhibitors.


Assuntos
Encefalite por Herpes Simples/induzido quimicamente , Herpes Genital/tratamento farmacológico , Citrato de Sildenafila/efeitos adversos , Barreira Hematoencefálica/fisiopatologia , Encefalite por Herpes Simples/fisiopatologia , Encefalite por Herpes Simples/virologia , Herpes Genital/fisiopatologia , Herpes Genital/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Permeabilidade , Citrato de Sildenafila/administração & dosagem
6.
BMC Cancer ; 16: 233, 2016 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-26988237

RESUMO

BACKGROUND: Systemic chemotherapy combined with steroids used as prophylactic antiemetics have been reported to induce immunosuppression. Further, herpes simplex virus-1 (HSV-1) infection has been reported to occur in patients with small cell carcinomas after chemoradiotherapy that includes brain irradiation. Here, we report a case of HSV-1 encephalitis that occurred in a patient undergoing chemoradiotherapy for advanced esophageal cancer. CASE PRESENTATION: A 77-year-old woman received chemoradiotherapy (5-fluorouracil, 700 mg/m(2); cisplatin, 70 mg/m(2); and radiotherapy, 60 Gy in total) for stage III esophageal cancer. The total radiation dose was administered concurrently with the first two courses of chemotherapy, together with dexamethasone as a prophylactic antiemetic. Two days before completion of the fourth course of chemotherapy, the patient developed acute neurological symptoms of disorientation, clouding of consciousness, and fever. T2-weighted magnetic resonance imaging showed a high intensity area in the bilateral temporal lobes and insular cortex. Furthermore, DNA PCR testing of cerebrospinal fluid showed clear positivity for HSV-1 DNA, and the patient was diagnosed with herpetic encephalitis. Intravenous administration of acyclovir for 3 weeks led to gradual improvement of consciousness, and the patient was able to respond to verbal cues. CONCLUSION: In advanced esophageal cancer patients, standard treatment involves chemoradiotherapy and surgery. However, primary infection with or reactivation of endogenous latent HSV-1 in the brain cortex during chemoradiotherapy combined with administration of a steroid may compromise the benefits of treatment.


Assuntos
Aciclovir/administração & dosagem , Quimiorradioterapia/efeitos adversos , Encefalite por Herpes Simples/tratamento farmacológico , Neoplasias Esofágicas/tratamento farmacológico , Idoso , Cisplatino/efeitos adversos , Dexametasona/efeitos adversos , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/patologia , Encefalite por Herpes Simples/virologia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/virologia , Feminino , Fluoruracila/efeitos adversos , Herpesvirus Humano 1/efeitos dos fármacos , Herpesvirus Humano 1/patogenicidade , Humanos , Imageamento por Ressonância Magnética , Esteroides/efeitos adversos
8.
Klin Padiatr ; 226(3): 188-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24158893
9.
Clin Infect Dis ; 57(6): 849-52, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23728144

RESUMO

We report on 20 natalizumab-treated patients with multiple sclerosis who developed laboratory-confirmed central nervous system (CNS) herpesvirus infections. In addition to progressive multifocal leukoencephalopathy, other CNS opportunistic infections have been rarely reported during natalizumab treatment. We encourage heightened awareness due to the risk for serious outcomes.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Varicela Zoster/induzido quimicamente , Meningite Viral/induzido quimicamente , Adulto , Anticorpos Monoclonais Humanizados/uso terapêutico , Feminino , Herpesvirus Humano 3/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/virologia , Natalizumab , Simplexvirus/isolamento & purificação
10.
Mult Scler ; 18(6): 909-11, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22048950

RESUMO

In this case report we describe the first non-fatal herpes simplex virus encephalitis (HSE) case with natalizumab for multiple sclerosis (MS). A 36-year-old woman, previously treated with immunomodulatory and immunosuppressive drugs for MS, developed acute encephalitis after 6 monthly natalizumab perfusions. Brain imaging demonstrated suggestive bi-temporal lesions. Herpes simplex virus type-1 DNA was detected in cerebrospinal fluid. The patient improved gradually after a 21-day course of intravenous acyclovir, but neuropsychiatric changes remained 5 months later. Our non-fatal case of HSE and other reported cases of herpes infections provide evidence of an increased risk with natalizumab and point to the need for clinicians to maintain awareness.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Encefalite por Herpes Simples/induzido quimicamente , Encefalite por Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1/efeitos dos fármacos , Fatores Imunológicos/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Aciclovir/administração & dosagem , Adulto , Anticorpos Monoclonais Humanizados/administração & dosagem , Antivirais/administração & dosagem , Cognição/efeitos dos fármacos , DNA Viral/líquido cefalorraquidiano , Esquema de Medicação , Encefalite por Herpes Simples/diagnóstico , Encefalite por Herpes Simples/psicologia , Encefalite por Herpes Simples/virologia , Feminino , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/patogenicidade , Humanos , Fatores Imunológicos/administração & dosagem , Infusões Intravenosas , Imageamento por Ressonância Magnética , Memória/efeitos dos fármacos , Natalizumab , Fatores de Tempo , Resultado do Tratamento , Ativação Viral/efeitos dos fármacos
11.
Med J Aust ; 195(2): 87-8, 2011 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-21770880

RESUMO

A 62-year-old woman with an autoimmune disease presented with panuveitis and was treated with immune suppression. She subsequently developed herpetic acute retinal necrosis and later died of herpes simplex encephalitis. Acute retinal necrosis usually occurs months to years after herpes simplex encephalitis. In our case, the ocular findings were present for 5 weeks before the encephalitis presented. To our knowledge, this is the first Australian case of acute retinal necrosis preceding herpes simplex encephalitis.


Assuntos
Encefalite por Herpes Simples/induzido quimicamente , Glucocorticoides/efeitos adversos , Pan-Uveíte/tratamento farmacológico , Prednisolona/efeitos adversos , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Encefalite por Herpes Simples/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1/efeitos dos fármacos , Humanos , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Síndrome de Necrose Retiniana Aguda/induzido quimicamente
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