Behçet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster

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  • Koto Serina
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan Department of Rheumatology, Sasebo City General Hospital, Japan
  • Umeda Masataka
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan Medical Education Development Center, Nagasaki University Hospital, Japan
  • Kawano Hiroaki
    Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Endo Yushiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Shimizu Toshimasa
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Koga Tomohiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Ichinose Kunihiro
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Nakamura Hideki
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
  • Mukaino Akihiro
    Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, Japan
  • Higuchi Osamu
    Department of Clinical Research, Nagasaki Kawatana Medical Center, Japan
  • Nakane Shunya
    Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, Japan
  • Kawakami Atsushi
    Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan

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Other Title
  • Behcet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster

Abstract

<p>A 58-year-old Japanese woman with herpes zoster developed Behçet's disease (BD) with symptoms including orthostatic intolerance as an autonomic disorder. Multiple immune-suppressive therapies and a β-blocker successfully controlled both the disease activity of BD and the autonomic disorders. A cytokine multiplex analysis of her serum revealed the elevation of proinflammatory cytokines [interleukin (IL)-1, IL-6, IL-12, tumor necrosis factor alfa (TNFα), and interferon gamma (IFN-γ)] and a low IL-10 concentration. IL-10 production is reported to be important for defense against herpes zoster virus (VZV). Insufficient IL-10 production is reported in BD. The reactivation of VZV with this cytokine profile suggests that BD will develop with various symptoms, including severe autonomic disorders. </p>

Journal

  • Internal Medicine

    Internal Medicine 59 (8), 1099-1104, 2020-04-15

    The Japanese Society of Internal Medicine

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