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A 18-year old female developed polyarthralgia and Raynaud's phenomenon in 1973. She was admitted to the hospital because of recurrent fever in 1976, and diagnosed as having SLE, manifested by facial butterfly rash, nonerosive arthritis, proteinuria, leukopenia, positive LE cell preparation, abnormal titer of antinuclear antibody and anti-DNA antibody. The patient had episodes of herpes zoster at 4, 28, 38, 52 and 59 months after initial symptoms of SLE. The course of herpes zoster was favorable and all episodes resolved without complications. She had deficiency in cell-mediated immunity, such as skin tests with PPD, DNCB, and IgG Fc receptor positive T cells. But the abnormalities were found both with and without herpes zoster infection. Decrease of complement titer was observed whenever herpes zoster occurred. She first suffered from herpes zoster prior to the initiation of steroid theroid therapy, and received prednisolone at doses from 12.5mg to 30 mg daily on 4 episodes of herpes zoster. It seemed that one of the causes on the multiple zoster infections, which were observed in early time after the onset of SLE, was low level of serum complement.

A case of systemic lupus erythematosus with five episodes of herpes zoster