Varicella-zoster virus vasculopathy in a multiple sclerosis patient on fingolimod

In the past decade, a variety of medications have come on the market to treat relapsing remitting multiple sclerosis (RRMS). Fingolimod, a functional antagonist of sphingosine 1-phosphate (S1P) receptors, reduces relapse frequency, MRI activity and disease progression. However, several side effects have been described – notably, heart block, macular edema, transaminitis, and infections. Varicella-zoster virus (VZV) cutaneous reactivation (shingles) is a well-known complication, but VZV vasculopathy has only been reported once [1].

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