대상포진의 중추신경계 침범에 관련된 요인
Determinants of Central Nervous System Involvement in Herpes Zoster
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. Central nervous system(CNS) involvements are uncommon complications of herpes zoster. The exact mechanism and risk factors are still unknown. Methods: We retrospectively reviewed the clinical data of patients who was admitted at our hospital due to herpes zoster from 2003 to 2013. The patients under age 15, herpes zoster infection without skin lesions, and cases not confirmed by a dermatologist were excluded. CNS involvements are defined as meningitis, encephalitis, single or multiple cranial neuropathies and all cases were evaluated with brain magnetic resonance imaging, spinal tapping, serological tests and confirmed by a neurologist. We compared the herpes zoster patients with CNS involvement to those without CNS involvement. Age, sex, body mass index, associated chronic medical illnesses, site and extent of skin lesion and development of post herpetic neuralgia were compared between two groups. Results: Total 1,131 subjects (male 460, female 671) were recruited. A group with CNS involvement was 91(8.04%). Sex, body mass index, associated chronic medical illnesses, extent of skin lesion were not different between two groups. A group with CNS involvement showed younger age(p<0.01), more facial and cervical skin lesions(p<0.01), lesser development of post herpetic neuralgia(p=0.048). Conclusions: CNS involvement is not a rare complication of herpes zoster and more frequent in patients with younger age and faciocervical zoster.
Abstract
Background: Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. Central nervous system(CNS) involvements are uncommon complications of herpes zoster. The exact mechanism and risk factors are still unknown. Methods: We retrospectively reviewed the clinical data of patients who was admitted at our hospital due to herpes zoster from 2003 to 2013. The patients under age 15, herpes zoster infection without skin lesions, and cases not confirmed by a dermatologist were excluded. CNS involvements are defined as meningitis, encephalitis, single or multiple cranial neuropathies and all cases were evaluated with brain magnetic resonance imaging, spinal tapping, serological tests and confirmed by a neurologist. We compared the herpes zoster patients with CNS involvement to those without CNS involvement. Age, sex, body mass index, associated chronic medical illnesses, site and extent of skin lesion and development of post herpetic neuralgia were compared between two groups. Results: Total 1,131 subjects (male 460, female 671) were recruited. A group with CNS involvement was 91(8.04%). Sex, body mass index, associated chronic medical illnesses, extent of skin lesion were not different between two groups. A group with CNS involvement showed younger age(p<0.01), more facial and cervical skin lesions(p<0.01), lesser development of post herpetic neuralgia(p=0.048). Conclusions: CNS involvement is not a rare complication of herpes zoster and more frequent in patients with younger age and faciocervical zoster.
참고문헌 (30)
- Weinberg JM, "Herpes zoster: epidemiology, natural history, and common complications", J Am Acad Dermatol, 57(6 Suppl), pp.S130~S135 (2007)
- Kennedy PG, "Varicella-zoster virus latency in human ganglia", Rev Med Virol, 12, pp.327~334 (2002)
- Gilden DH, "Clinical and molecular pathogenesis of varicella virus infection", Viral Immunol, 16, pp.243~258 (2003)
- Gilden D, "Neurological disease produced by varicella zoster virus reactivation without rash", Curr Top Microbiol Immunol, 342, pp.243~253 (2010)
- Nagel MA, "The varicella zoster virus vasculopathies clinical, CSF, imaging, and virologic features", Neurology, 70, pp.853~860 (2008)
- Koskiniemi M, "Acute central nervous system complications in varicella zoster virus infections", J Clin Virol, 25, pp.293~301 (2002)
- Schmader K, "Herpes zoster and postherpetic neuralgia in older adults", Clin Geriatr Med, 23, pp.615~632 (2007)
- "Ramsay Hunt Syndrome/:" (2009)[URL]
- Sweeney CJ, "Ramsey Hunt syndrome", J Neurol Neurosurg Psychiatry, 71, pp.149~154 (2001)
- Peterslund NA, "Herpesvirus infection: an overview of the clinical manifestations", Scand J Infect Dis Suppl, 80, pp.15~20 (1991)
- Steiner I, "The neurotropic herpes viruses:herpes simplex and varicella-zoster", Lancet Neurol, 6, pp.1015~1028 (2007)
- Hope-Simpson RE, "The nature of herpes zoster; a long-term study and a new hypothesis", Proc R Soc Med, 58, pp.9~20 (1965)
- Thomas SL, "What does epidemiology tell us about risk factors for herpes zoster?", Lancet Infect Dis, 4, pp.26~33 (2004)
- Ragozzino MW, "Risk of cancer after herpes zoster: a population-based study", N Engl J Med, 307, pp.393~397 (1982)
- Livengood JM, "The role of stress in the development of herpes zoster and postherpetic neuralgia", Curr Rev Pain, 4, pp.7~11 (2000)
- Schmader K, "Racial and psychosocial risk factors for herpes zoster in the elderly", J Infect Dis, 178(Suppl 1), pp.S67~S70 (1998)
- Schmader K, "Race and stress in the incidence of herpes zoster in older adults", J Am Geriatr Soc, 46, pp.973~977 (1998)
- Hicks LD, "Family history as a risk factor for herpes zoster: a case-control study", Arch Dermatol, 144, pp.603~608 (2008)
- Kennedy PG, "Key issues in varicella-zoster virus latency", J Neurovirol, 8, pp.80~84 (2002)
- Mitchell BM, "Herpes simplex virus-1 and varicella-zoster virus latency in ganglia", J Neurovirol, 9, pp.194~204 (2003)
- Arvin AM, "Varicella-zoster virus", Clin Microbiol Rev, 9, pp.361~381 (1996)
- Donahue JG, "The incidence of herpes zoster", Arch Intern Med, 155, pp.1605~1609 (1995)
- Yawn BP, "A population-based study of the incidence and complication rates of herpes zoster", Mayo Clin Proc, 82, pp.1341~1349 (2007)
- Helgason S, "Prevalence of postherpetic neuralgia after a single episode of herpes zoster: prospective study with long term follow up", BMJ, 321, pp.794~796 (2000)
- Brisson M, "Epidemiology of varicella zoster virus infection in Canada and the United Kingdom", Epidemiol Infect, 127, pp.305~314 (2001)
- Insinga RP, "The incidence of herpes zoster in a United States administrative database", J Gen Intern Med, 20, pp.748~753 (2005)
- de Melker H, "The epidemiology of varicella and herpes zoster in The Netherlands:implications for varicella zoster virus vaccination", Vaccine, 24, pp.3946~3952 (2006)
- Jung BF, "Risk factors for postherpetic neuralgia in patients with herpes zoster", Neurology, 62, pp.1545~1551 (2004)
- Kim SK, "Neurologic complication of herpes zoster", J Korean Neurol Assoc, 12, pp.715~722 (1994)
- Ha KS, "Clinical correlation with CSF findings of herpes zoster", J Korean Neurol Assoc, 15, pp.1293~1299 (1997)
