Headache and vision changes in an elderly man with rheumatoid arthritis

We present a case of an elderly, immunosuppressed patient with rheumatoid arthritis who was not appropriately vaccinated, and subsequently developed herpes zoster ophthalmicus, which initially presented similar to giant cell arteritis. Evidence‐based vaccinations are integral in decreasing the incid...

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Bibliographic Details
Published in:International journal of rheumatic diseases 2019-07, Vol.22 (7), p.1331-1334
Main Authors: Kwok, Timothy S.H., Daneman, Nick, Lake, Shirley L.
Format: Article
Language:English
Subjects:
Aged, 80 and over
Antirheumatic Agents - adverse effects
Antiviral Agents - therapeutic use
Arteritis
Arthritis, Rheumatoid - diagnosis
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - immunology
Autoimmune diseases
Complications
Geriatrics
giant cell arteritis
Headache
Headache - diagnosis
Headache - drug therapy
Headache - immunology
Headache - virology
Herpes zoster
Herpes zoster ophthalmicus
Herpes Zoster Ophthalmicus - diagnosis
Herpes Zoster Ophthalmicus - drug therapy
Herpes Zoster Ophthalmicus - immunology
Herpes Zoster Ophthalmicus - virology
Herpesvirus 3, Human - drug effects
Herpesvirus 3, Human - immunology
Herpesvirus 3, Human - pathogenicity
Humans
Immunocompromised Host
Inflammation
Male
Opportunistic Infections - diagnosis
Opportunistic Infections - drug therapy
Opportunistic Infections - immunology
Opportunistic Infections - virology
Rheumatoid arthritis
Rheumatology
Treatment Outcome
Vaccination
Vein & artery diseases
Vision
Vision Disorders - diagnosis
Vision Disorders - drug therapy
Vision Disorders - immunology
Vision Disorders - virology
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Description
Summary:We present a case of an elderly, immunosuppressed patient with rheumatoid arthritis who was not appropriately vaccinated, and subsequently developed herpes zoster ophthalmicus, which initially presented similar to giant cell arteritis. Evidence‐based vaccinations are integral in decreasing the incidence of preventable diseases and promoting optimal health at the individual and population level. Although the patient ultimately did not suffer any long‐term adverse sequelae, this case highlights the importance of vaccination in the rheumatology setting, and to consider both inflammatory and infectious causes of headache and vision changes in the elderly.
ISSN:1756-1841
1756-185X
DOI:10.1111/1756-185X.13589