Clinical progression of chikungunya fever during acute and chronic arthritic stages and the changes in joint morphology as revealed by imaging
Autor(es): Manimunda Sathya Prakash, Vijayachari Paluru, Uppoor Raghuraj, Sugunan Attayur Purushottaman, Singh Shiv Shankar, Rai Subhodh Kumar, Sudeep Anakkathil Balan, Murugan-am Nagarajan, Chaitanya Itta Krishna, Guruprasad Dev Reddy
Resumo: This longitudinal follow-up study of 203 patients with serologically confirmed chikungunya (CHIK) virus infection describes the clinical features of CHIK fever during the first - tenth months of illness. During the acute stage CHIK fever presents with a wide array of symptoms. The foremost chronic symptoms at the end of a month were rheumatism (75%) - fatigue (30%). During the tenth month of follow-up the symptoms/signs observed were joint pain/swelling (46%), fatigue (13%) - neuritis (6%). The cure rate at the end of 9 months was 51%. Among the patients who had joint pain, 36% (34/94) met the American College of Rheumatology criteria to classify them as having rheumatoid arthritis. A subpopulation of the patients with joint pain (20/94) was tested for rheumatoid factor (RF) - anti-cyclic citrullinated peptide (anti-CCP) antibody, - the joints were imaged by X-ray - magnetic resonance imaging (MRI). All tested negative for RF - one tested positive for anti-CCP. A radiolucent lesion in the X-ray was seen in the bones of five patients. The MRI findings were joint effusion, bony erosion, marrow oedema, synovial thickening, tendinitis - tenosynovitis. The study proves with relative certainty that CHIK arthritis is chronic inflammatory erosive arthritis, which has implications for management of the infection.
Palavras-Chave: Chikungunya virus; Disease progression; Joint pain; Bony erosion; Inflammatory; Arthritis; India
Imprenta: Transactions of the Royal Society of Tropical Medicine and Hygiene, v. 104, n. 6, p. 392-399, 2010
Identificador do objeto digital: 10.1016/j.trstmh.2010.01.011
Descritores: Chikungunya virus - Pathogenesis ; Chikungunya virus - Viral infections ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Public health
Data de publicação: 2010
