Chicken pox virus

[30048]

I have had a cataract operation and can now see to   post .  Something that has been bothering me is a link that was posted awhile ago about GCA being linked to the Shingles virus.  I have had GCA since 2012 and recently ( last June) came down with shingles. At the time someone else posted that her symptoms were helped by the anti viral  given for shingles.  I concurred.  PMR pro thought that it might be that the brain could only deal with one pain at a time...( there was a name for the theory). Anyway...the study said there was compelling evidence that the onset in the elderly was linked to the varicella zoster virus.  My question ....why can't we take the anti viral medicine ?  I still have nerve pain connected to the shingles and sometimes have a hard time differentiating the pain .  Just a thought.

[PMRpro Ambassador]

There ISN'T compelling evidence that GCA is caused by varicella zoster - one study found traces of varicella zoster in temporal artery biopsies in a large proportion of patients with GCA. But there were also some patients where they DIDN'T find any sign of the virus. And FINDING something correlates with something else doesn't mean that it was the cause of either. The authors are claiming it is compelling but the work will have to be replicated - which as far as I know it hasn't been yet - but there is also the point that there are some people where it doesn't apply so that could suggest that there is more than one cause of GCA, which is actually extremely likely and someone did comment that in a report of the claims. 

Both PMR and GCA are forms, maybe the same form, of autoimmune vasculitis. Autoimmune disorders are caused by the immune system going haywire for some reason - probably overload after repeated assaults by stress, infection, trauma and so on until the straw breaks the camel's back. Infection with the virus that causes chicken pox and shingles is one possibility. But you may have been infected years before - the chicken pox virus doesn't leave the body, it goes into hibernation in nerve endings until something reactivates it and you develop shingles. You can't catch shingles from someone but someone who hasn't had chicken pox can catch it from someone with shingles. So yes, the virus may be present - but that doesn't necessarily mean it is the direct cause of the GCA - and the antivirals only work when the virus is active. The nerve pain now is also probably due to damage done to the nerve rather than continuing infection.

Just as my flare began a few months ago I was given antibiotics for a couple of days - I also felt well for a few days afterwards and others have said the same when they have had abx, it also happens in some people with RA. But it doesn't really mean that is another option - and using abx long term is another problem.

[30048 in reply to PMRpro]

Thank you for your informed opinion. I always look for your comments. I guess it doesn't matter, at this point, just what caused my immune system to go haywire ....I was just hoping for some relief

[Grimo]

I have had GCA since 2012" can I ask if you are still on pred? If so how many now are you taking?  

[30048]

Yes.  I got down to 7 milligrams and could not get any further.  Had a flare and was back up to 80 ( I had my optic nerve leak ...at the onset and then with the flare. ) and presently on 12 milligrams.  The doctor is hoping I can get to 10 on the slow method.

[Judigardener]

Hello. I've had repeated shingles attacks since 9

months  after my late husband was killed in Dec 1997. I have PMR. Diagnosed in Nov 2013. Been up and down tapering. But back on 10mg and reasonably stable at present. I am on Valaciclovir one a day as a prophylactic against the repeated shingles. So far so good. Not had an attack for a while and quite a bit of stress which usually acts as a trigger. 

[30048]

Have you found the medicine to help at all in warding off the shingles return ?  I have been on gabapentem at night but don 't find that doing much,  

[notnice]

Hi 30048

I am not too sure GCA is connected with shingles.  I had shingles November 2013 and diagnosed with GCA March 2015, my GP assured me that there was no connection when I asked.

I hope things go well for you and you get more sorted soon.

Take care

Notnice