» Articles » PMID: 39872708

Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination Immunosuppression

Overview
Publisher Wiley
Date 2025 Jan 28
PMID 39872708
Authors
Affiliations
Soon will be listed here.
Abstract

Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.

References
1.
Ghoreschi K, Laurence A, OShea J . Janus kinases in immune cell signaling. Immunol Rev. 2009; 228(1):273-87. PMC: 2782696. DOI: 10.1111/j.1600-065X.2008.00754.x. View

2.
Berinstein J, Aintabi D, Higgins P . In-hospital management of inflammatory bowel disease. Curr Opin Gastroenterol. 2023; 39(4):274-286. PMC: 11227907. DOI: 10.1097/MOG.0000000000000953. View

3.
Berinstein E, Sheehan J, Jacob J, Steiner C, Stidham R, Shannon C . Efficacy and Safety of Dual Targeted Therapy for Partially or Non-responsive Inflammatory Bowel Disease: A Systematic Review of the Literature. Dig Dis Sci. 2023; 68(6):2604-2623. PMC: 9942632. DOI: 10.1007/s10620-023-07837-0. View

4.
Berinstein J, Karl T, Patel A, Dolinger M, Barrett T, Ahmed W . Effectiveness of Upadacitinib for Patients With Acute Severe Ulcerative Colitis: A Multicenter Experience. Am J Gastroenterol. 2024; . PMC: 11427599. DOI: 10.14309/ajg.0000000000002674. View

5.
Farraye F, Melmed G, Lichtenstein G, Kane S . ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease. Am J Gastroenterol. 2017; 112(2):241-258. DOI: 10.1038/ajg.2016.537. View