Case Report

Varicella-zoster virus hepatitis in polymyositis

Authors

Fumitaka Mizoguchi¹, Satsuki Nakamura¹, Hideyuki Iwai¹, Tetsuo Kubota¹ and Nobuyuki Miyasaka¹

1. Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

Received:

23 October 2007

Accepted:

10 January 2008

Published online:

25 March 2008

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Abstract

A 31-year-old woman had recurrent mild flare-ups of polymyositis for years. Fourteen days after low-dose methotrexate was added in an attempt to taper the corticosteroid, she began to feel abdominal and lower back pain, followed by generalized pustulosis, severe liver dysfunction, and disseminated intravascular coagulation. On the diagnosis of varicella-zoster virus (VZV) hepatitis, acyclovir, immune globulin and plasmapheresis were given with a favorable outcome. Physicians should be aware that VZV infection could complicate severe hepatitis in immuno-suppressed patients.

Key words

Varicella-zoster virus - Hepatitis - Polymyositis - Corticosteroids - Methotrexate