Spondylitis Association of America Forums General Discussion General Message Board for Ankylosing Spondylitis and Related Diseases Shingles????

Happy Boxing Day everyone!

Apparently I've got a case of shingles for Christmas.I went to the doctor today to check out my sore shoulder and numb thumb and forearm, thinking it could be a trapped nerve or maybe the numbness was a side effect from the Enbrel or mtx. I only mentioned the itchy rash in passing (I thought it was from the sun) and she looked at it and said "Aha, that looks like shingles". The rash is mostly on the same arm as the numbness, but a bit on the other side too, which is apparently not typical. It seems a bit atypical all round, but I have to assume she knows what she's talking about...

There are definitely mixed messages on the internet about how contagious it is and to whom. When I asked the nurse she said I could give people chicken pox if they haven't already had it, but also to avoid contact with the immune-suppressed and the elderly as they could be affected even if they've had chickenpox already. A bit late now as we've been spending time with family including elderly parents and doing lots of hugging as you do at Christmas...

Hi, Shirley:

I have wondered whether colloidal silver has any use against shingles. Have known several people who developed very painful conditions, but only after the fact.

Sometimes I get a psoriatic patch even after overcoming the basic AS symptoms through diet and antibiotics, but now rather lax diet and AS remains inactive (ESR<10 even at my advanced age...).

Hope this resolves rapidly, whatever You are trying,
HEALTH,
John

Thanks John I'm taking anti viral medication for a week will see how it goes after that.

You need to contact your rheumatologist immediately. (Your GP should have done so.). Shingles while on a TNF inhibitor is a very big deal and should be monitored very closely.

Thanks his office is closed until mid January for Christmas holidays. Its a crazy time here as its the main summer holiday time. I'll try emailing him. I've assumed I shouldn't take enbrel or methotrexate in the meantime but not sure what else I should watch out for. The doctor I saw at an after hours centre said to come back if I feel worse.

Being on an anti-TNF puts you at increased risk of systemic or disseminated shingles. In someone with an altered immune system, systemic shingles can affect the central nervous system, the bloodstream, and the internal organs. It can lead to encephalitis, sepsis, and in very rare cases death. You should certainly stop both Enbrel and methotrexate, but you should also be treated with anti-virals and monitored for complications - including the possibility of going systemic. Patients with systemic shingles are generally hospitalized for IV anti-viral (and occasionally steroid) therapy. I am not trying to worry you unnecessarily, but shingles can become a very big deal while on an anti-TNF. Please be very careful.

I understand that your rheumatologist's office is closed until mid January, but surely he must have some other rheumatologist covering for him?

Thanks. Yes I am on antiviral meds. Not sure who is covering but will try to find out. Im actually on holiday in a different city and the country virtually closes down over the festive seadon which also complicates things.

The office answer phone said to dial 111 if its an emergency or ring your family doctor. Family doctor will maybe be open on Monday.

The rash is not bad but it is on both arms and I feel a bit off colour. I could go back to the after hours centre but don't really feel likr the 3 hour wait.

Hi Shirley,
So sorry to hear you've come down with this. I am currently taking Remicade and MTX and I will develop shingles on the back of my neck every so often. It is usually the week following my infusion (assumably when my immune system is at its lowest).

I have a standing Rx for antiviral meds and it usually clears up after a week. I have never stopped any other meds while taking the antiviral, and get regular checks of blood with my rheumy.

I am not a doctor, and would always advise you to exercise caution when dealing with shingles, but in my experience, there is no excess danger than what you might encounter with your normal regimen of meds.

Good luck and best wishes for a speedy resolution!

Thanks Greg. I'm working on the assumption that I've got a mild case as I'm really not feeling too bad. The numbness is odd and the rash is a bit itchy but the pain isnt bad with the usual meloxicam with the occasional paracetamol. I am taking the antivirals and holding off on the enbrel and mtx in the meantime.