MMF and chicken pox

Hi,

I am off prednisolone for 4 months and on MMF for 6 months. I have also had splenectomy 10 years ago. I am going to celebrate Christmas with a family with kids who are having or just had chicken pox. I had chicken pox 20 years ago in my early teens. But I'm a bit concerned now as I was immunosuppressed recently - is my immune system wiped out now and I could get it again? And if so, how dangerous it would be for me?

11 Replies

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  • Hi,

    If you have had chicken pox,and most of us have, the virus is always in your body hiding in a nerve end. If your system is immuno-compromised then you are at risk of getting shingles but not chicken pox.You cannot pass on shingles ,but when at the infectious stage can pass on chicken pox to those who have not had the disease. I have been on MMF since June 2011 and now have a mild attack of shingles, brought on I think by stress. My immune system is severely compromised for the ITP ,but like you I often wonder just what is the amount of immuno-supression.Good luck and at this time of year be more careful of common colds, etc.

  • Hi Kered, many thanks for your reply, it makes me much less worried. I also remembered that I have already had a contact with chicken pox infection once, after I had my spleen removed and few prednisolone treatments and I didn't get it. So if MMF doesn't act too differently from prednisolone I hope to be fine.

  • The chicken pox virus stays in our system forever once we have had it and it can reawaken at any time in the form of shingles. Being exposed to anyone who has recently had or has got chicken pox could well trigger off shingles in anyone who is immuno suppressed or spleenless. i had shingles in 2009 at exactly this time of year and it is the most painful thing I have ever had. I still get some itchiness from it even now. Shingles developed because I had been on Prednisolone on and off for 4 years. If I were in your position I would be very careful and chat it through with your specialist or doctor first. Shingles really is so painful and potentially very damaging so best be safe than sorry. Many apologies for being the harbinger of a gloomy response but its just better to be cautious.

  • Hi Anthony, thanks for the warning - and don't be sorry, I do appreciate it. I was going to call my doctor anyway, I hope I can reach her before holiday season. Is shingles very persistent and hard to get rid of? Also, I have been exposed to chicken pox once post-prednisolone already, that time it went ok.

  • Shingles is a difficult virus to shift and very painful. It is also potentially damaging too so absolutely to be avoided at all costs. I was put on a course of anti viral tablets for about ten days and that cleared up the worst of the rash and inflammation but it does still last for ages afterwards. As I say I still itch a bit from it even now and it can be very dangerous in some cases.

  • Thanks, Anthony. Yes, I heard shingles could be long-lasting and difficult. I've done some more research meanwhile and here is what I found on NHS site - will post here, readers might find it useful: "It is possible to catch chickenpox from someone with shingles, but not the other way around." nhs.uk/conditions/chickenpo...

    So it seems that, unless I don't have immunity against chickenpox itself anymore which I hope isn't the case, it should be ok.

  • Anthony raises some interesting points for those of us who live with immunosuppressed systems as part of our ITP treatment. We are all at risk from opportunistic and latent diseases.My shingles I am sure was brought on by stress which added more imposition on an already weakened system. But I more concerned about other infections such as the common cold,pneumonia,blood sepsis etc. and take as many precautions as I can.Yes shingles can be painful and long lasting (I have been very lucky),but I would still like to know if there is any way of assessing how much our own systems are suppressed,taking age into consideration. We all have to carry on as normal as life as we can and many of us have young grandchildren of school age who get diseases like chicken pox etc. For me MMF is working well but would trying something life rituximab or a TPO be a safer option.

  • Indeed, that's an interesting question. Maybe there are some research articles on that topic - e.g., whether we are more susceptible to different kinds of diseases when on MMF and by what extent. I didn't have this discussion with my doctor before but will try to ask about it as soon as I can reach her.

  • Rituximab is an immunosuppressant too but i don't know how it compares with MMF. When I had MMF I had constant urinary tract infections but then I've since found out that I've got a rotten immune system anyway so was doubly immunosuppressed.

  • Following my Rirtuximab treatment my specialist advised me that I would be very vulnerable to colds, viruses, flu, just about anything for 6 months. I actually got a rotten cold after my first dose of Rituximab and had to delay my second course of treatment for 10 days. Even so my platelet count still increased from 34 to 119 after that first dose of Rituximab despite having the awful cold. Platelet count has stayed over 100 ever since August 2010, peaking at 190 and last count 134 in early November. Very grateful that Rituximab has worked so well for me, so far. Now just have 1/2 yearly check ups and have had no medication since August 2010.

  • Im not sure I have had the same problem as yall. I was diagnosed wit idiopathic ITP about 17 years ago. My platelet count was 2000 when they found it. They started me on prednisone 80 mg 3x a day. I was in the hospital for a few weeks till my count went up to 35,000. I stayed on prednisone for 6 months but when they tried to taper me off my count dropped again. They decided to remove my spleen. I had to get IGIV before surgery to raise my count rapidly. And may I say that the splenectomy was the worst surgery ever. (they tried laparoscopic but ended up having to open me up.) Since surgery my count has done very well, staying between 150,000 and 200,000. But my immune system sucks!!!! Still after 16 years after my surgery. I get sick all the time. I have several autoimmune diseases--psoriasis, fibromyalgia..etc. My question is I was told when they did my surgery that I needed to stay away from anyone with shingles or chickenpox cause I could get both. So does that mean I can get both of them? Cause I was around someone with shingles and now I have the burning pain the last few days on my mid back, hoping it doesnt form the rash. I cant tell if I have the other symptoms-flu like symptoms, aches, etc--cause I feel like that most the time from the fibromyalgia. Any ideas? Since the spleen holds our antibodies that our bodies collect does it even know that we have had any of the diseases as a child? Cause after I had surgery I got hoof and mouth disease again. Dr said it was cause my body didnt know I had ever had it cause my spleen was removed. What do yall think?

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