Herpes Zoster: A rare complication of Infliximab in severe Crohnʼs disease

Abstract

Crohn's disease is a chronic, inflammatory bowel disease of unknown cause. A significant development in the treatment of Crohn's disease has been the Introduction of Infliximab (Remicade),a chimeric monoclonal antibody that binds and neutralizes tumor necrosis factor alpha and also induces apoptosis in T cells. The most common side effects of Infliximab are infections and allergic reactions. Serious side effects include reactivation of tuberculosis, lymphoma and bone marrow depression. We would like to describe a severe uncommon side effect of Infliximab. A fifteen years old boy with Crohn's disease was admitted because of severe herpes zoster Crohn's disease was diagnosed at the age of 10 years with short stature, abdominal pain and diarrhea. He was treated with azathioprine, prednisone, antibiotics and growth hormone but could not achieve clinical remission. a course of three Infliximab infusions was given with marked clinical improvement. Three weeks after the last infusion he developed Herpes zoster infection which responded to intravenous acyclovir. This case report is, to our knowledge, the first report of Herpes Zoster infection as a complication of Infliximab administration.