Article in Japanese

A pediatric case of herpes zoster developed during administration of tofacitinib for treatment of ulcerative colitis

Takeshi YOSHINAGA^1）, Yoshiki KUSAMA^1）, Tadamori TAKAHARA^2）

We report a pediatric case of herpes zoster that developed during administration of tofacitinib for treatment of ulcerative colitis. A 12-year-old male adolescent was diagnosed with refractory ulcerative colitis, and tofacitinib therapy was initiated 3 months prior to his visit. He observed painful reddish rash with multiple blisters across his right anterior chest and back, the morning of his visit. The patient received a diagnosis of herpes zoster based on the characteristic rash and was admitted to the hospital. Tofacitinib therapy was discontinued and intravenous acyclovir was administered, which led to improvement in symptoms. Intravenous acyclovir was switched to oral valacyclovir therapy on the fourth day of hospitalization, and the patient was discharged. Tofacitinib treatment was re-initiated after a 10-day course of antiherpetic therapy.
Tofacitinib is the only Janus kinase inhibitor approved for treatment of ulcerative colitis in adult patients under the health insurance scheme in Japan. Herpes zoster is known to occur following reactivation of the varicella-zoster virus in adults under the administration of tofacitinib; however, few reports have described herpes zoster in children. Molecular target drugs are used in the pediatric population in inflammatory bowel diseases in recent times; nevertheless, the evidence regarding the use of molecular target drug in these patients are limited. Accumulation of a greater number of reports is warranted to use these drugs appropriately in this patient population.

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1）Division of General Pediatrics, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center
2）Division of Pediatric Allergy, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center

Key words	Janus kinase inhibitor, tofacitinib, shingles, varicella-zoster virus, reactivation
Received	December 20, 2021
Accepted	March 14, 2022

34 (2)：112─117,2022