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Post-varicella vaccination uveitis in a child with nephrotic syndrome receiving immunosuppressive treatment : a case report

datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorAndrade, Catarina
dc.contributor.authorCordeiro, Miguel de Almeida
dc.contributor.authorBaptista, Rute Baeta
dc.contributor.authorNunes, Beatriz Sousa
dc.contributor.authorGarcia, Ana Margarida
dc.contributor.authorSilva, Tiago Milheiro
dc.contributor.authorPinto, Marta Valente
dc.date.accessioned2026-05-20T14:29:24Z
dc.date.available2026-05-20T14:29:24Z
dc.date.issued2025-04
dc.description.abstractPatients with nephrotic syndrome are at heightened risk of infections due to the underlying disease pathophysiology and the effects of immunosuppressive therapies. Varicella-zoster virus (VZV) infection can cause severe complications in immunocompromised individuals. Concerns about the safety of live attenuated vaccines in this population persist. Emerging vaccination strategies incorporate pre-vaccination risk stratification algorithms based on immunological criteria. We present a case of a five-year-old male with corticosteroid-dependent nephrotic syndrome, in complete remission on mycophenolate mofetil therapy, who received the varicella vaccine after meeting immunocompetence criteria. Fourteen days post-vaccination, he developed scant vesicular lesions, with VZV DNA detected by PCR via swab. By day 16 post-vaccination, he presented with left-eye panuveitis. VZV DNA was also detected in the blood by PCR. Differentiation of VZV vaccine strains from wild-type strains was not possible. Additionally, molecular testing for VZV in the aqueous humor was not performed. However, given the temporal association with varicella vaccination, the detection of VZV in the blood and cutaneous lesions, and most importantly, the immunosuppression of the patient, post-vaccination ocular varicella was assumed even without an epidemiological history of varicella exposure. This case highlights the importance of a thorough immunocompetence assessment before administering live vaccines to immunosuppressed patients, as well as close post-vaccine monitoring and a high index of suspicion for complications to optimize vaccine safety in this vulnerable group. Patients with nephrotic syndrome require vaccination strategies tailored to their individual risk.eng
dc.identifier.citationAndrade C, de Almeida Cordeiro M, Baeta Baptista R, Sousa Nunes B, Garcia AM, Milheiro Silva T and Valente Pinto M (2025) Post-varicella vaccination uveitis in a child with nephrotic syndrome receiving immunosuppressive treatment: a case report. Front. Pediatr. 13:1567164. doi: 10.3389/fped.2025.1567164
dc.identifier.doi10.3389/fped.2025.1567164
dc.identifier.issn2296-2360
dc.identifier.urihttp://hdl.handle.net/10400.26/63219
dc.language.isoeng
dc.peerreviewedyes
dc.publisherFrontiers Media
dc.relation.hasversionhttps://doi.org/10.3389/fped.2025.1567164
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectattenuated vaccine
dc.subjectimmunocompromised patient
dc.subjectnephrotic syndrome
dc.subjectuveitis
dc.subjectvaricella vaccine
dc.titlePost-varicella vaccination uveitis in a child with nephrotic syndrome receiving immunosuppressive treatment : a case reporteng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.startPage1567164
oaire.citation.titleFrontiers in Pediatrics
oaire.citation.volume13
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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