{
  "abstract": "Methotrexate (MTX) and Janus kinase (JAK) inhibitors are effective treatments for rheumatoid arthritis (RA); however, they may increase the risk of opportunistic infections. We herein report a case of a patient with RA receiving MTX and upadacitinib who developed an active cytomegalovirus (CMV) infection and Epstein-Barr virus (EBV) reactivation, complicated by CMV meningitis and virus-associated hemophagocytic lymphohistiocytosis (HLH). This case highlights that clinicians should consider not only herpes zoster, but also infection or reactivation involving non-VZV herpesviruses, including CMV and EBV, particularly in patients receiving JAK inhibitors in combination with other immunosuppressive agents.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "Kazuki Tomiyama"
    },
    {
      "name": "Soma Fukami"
    },
    {
      "name": "Toshitaka Yukishima"
    },
    {
      "name": "Haruka Yonezawa"
    },
    {
      "name": "Shin-ichiro Ohmura"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8rf58hgeqrsds.bib",
  "cited_by": 0,
  "doi": "10.2169/internalmedicine.8164-26",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8164-26/_article",
  "id": "8rf58hgeqrsds",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8164-26/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2713|Cytomegalovirus and herpesvirus research"
    ]
  ],
  "openalex": "W7221001356",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8164-26/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8rf58hgeqrsds.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.8164-26",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8164-26/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Cytomegalovirus and herpesvirus research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "An Active Cytomegalovirus Infection and Epstein-Barr Virus Reactivation Complicated by Cytomegalovirus Meningitis and Virus-Associated Hemophagocytic Lymphohistiocytosis during Methotrexate and Upadacitinib Therapy in a Patient with Rheumatoid Arthritis",
  "title_text": "An Active Cytomegalovirus Infection and Epstein-Barr Virus Reactivation Complicated by Cytomegalovirus Meningitis and Virus-Associated Hemophagocytic Lymphohistiocytosis during Methotrexate and Upadacitinib Therapy in a Patient with Rheumatoid Arthritis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/8rf58hgeqrsds",
  "venue": "Internal Medicine",
  "versions": []
}