{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:07:10Z","timestamp":1781104030446,"version":"3.54.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Efgartigimod (Efgartigimod alpha fcab, Vyvgart\u2122) is a pioneering neonatal Fc receptor (FcRn) antagonist for the treatment of severe autoimmune diseases mediated by pathogenic immunoglobulin G (IgG) autoantibodies, including myasthenia gravis (MG). It is a well-tolerated drug with minor side effects, such as headache and upper respiratory (lung) and urinary tract infections. Here, we present a case of Kaposi\u2019s varicelliform eruption (KVE) and herpetic conjunctivitis related to efgartigimod in a 60-year-old patient with ocular MG (OMG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>A 60-year-old Chinese male suffered from acetylcholine receptor antibody positive (AChR Ab+) OMG for 8 years. During this period, he underwent first-line treatment with systemic corticosteroids, cyclosporine, cyclophosphamide, and so on, but had poor symptom improvement. On the recommendation of his attending neurologist, he received one cycle of intravenous efgartigimod (10mg\/kg, once weekly for 4 weeks). The patient experienced fever, widespread painful blisters, and edema on the face on the third day after his last intravenous infusion. The patient also complained of increased secretions and a foreign body sensation in both eyes. Laboratory tests confirmed infection with herpes simplex virus (HSV). A diagnosis of efgartigimod-associated KVE and herpetic conjunctivitis was made. After intravenous administration (5mg\/kg, 3 times a day, every 8 hours) for 10 days, the patient was cured without residual complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case is the first report of a patient with KVE and herpetic conjunctivitis related to efgartigimod in PubMed. This is rare and unusual. Clinicians should be alert to the rare symptoms related to efgartigimod.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1409480","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T05:00:57Z","timestamp":1722488457000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Efgartigimod-associated Kaposi\u2019s varicelliform eruption and herpetic conjunctivitis in a patient with seropositive ocular myasthenia gravis: a case report and review"],"prefix":"10.3389","volume":"15","author":[{"given":"Lingzhi","family":"Ge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangli","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00547-z","article-title":"Getting specific: targeting Fc receptors in myas-thenia gravis","volume":"17","author":"L\u00fcnemann","year":"2021","journal-title":"Nat Rev Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1756286421997381","DOI":"10.1177\/1756286421997381","article-title":"The importance of FcRn in neuro-immu-notherapies: from IgG catabolism, FCGRT gene polymorphisms, IVIg dosing and efficiency to specific FcRn inhibitors","volume":"14","author":"Dalakas","year":"2021","journal-title":"Ther dv Neurol Disord"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00159-9","article-title":"Safety, efficacy, and tolerability of efgartigimod in patients with generalised myasthenia gravis (ADAPT): a multicentre, randomised, placebo-controlled, phase","volume":"20","author":"Howard","year":"2021","journal-title":"Lancet Neurol"},{"key":"B4","unstructured":"Vyvgart\u2122 (efgartigimod alfa-fcab) injection, for intravenous use: Initial U.S. Approval2021"},{"key":"B5","doi-asserted-by":"publisher","first-page":"62031","DOI":"10.1080\/08916934.2022.2104261","article-title":"Effect of FcRn antagonism on protective antibodies and to vaccines in IgG-mediated autoimmune diseases pemphigus and generalised myasthenia gravis","volume":"55","author":"Guptill","year":"2022","journal-title":"Autoimmunity"},{"key":"B6","doi-asserted-by":"publisher","first-page":"399","DOI":"10.4103\/2229-5178.169714","article-title":"Kaposi's varicelliform eruption: a case series","volume":"6","author":"Ferrari","year":"2015","journal-title":"Indian Dermatol Online J"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/ced.2018.43.issue-5","article-title":"A case of Kaposi varicelliform eruption progressing to herpes simplex virus hepatitis in an immunocompetent patient","volume":"43","author":"Okamoto","year":"2018","journal-title":"Clin Exp Dermatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"979","DOI":"10.3390\/v1030979","article-title":"Innate and adaptive immune responses to herpes simplex virus","volume":"1","author":"Chew","year":"2009","journal-title":"Viruses"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.20782","article-title":"Treatment of pemphigus vulgaris and foliaceus with efgartigimod, a neonatal Fc receptor inhibitor: a phase II multicentre, open-label feasibility trial","volume":"186","author":"Goebeler","year":"2022","journal-title":"Br J Dermatol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/ced.2008.33.issue-5","article-title":"Recalcitrant pemphigus foliaceus with Kaposi's varicelliform eruption: report of a fatal case","volume":"33","author":"Demitsu","year":"2008","journal-title":"Clin Exp Dermatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.38395","article-title":"Kaposi's varicelliform eruption after treatment with ixekizumab in a patient with pityriasis rubra pilaris","volume":"15","author":"Guenther","year":"2023","journal-title":"Cureus"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1409480\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T05:01:04Z","timestamp":1722488464000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1409480\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":11,"alternative-id":["10.3389\/fimmu.2024.1409480"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1409480","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,1]]},"article-number":"1409480"}}