Abstract
The chikungunya virus (ChikV) is a reemerging mosquito-borne pathogen that causes disabling chronic arthritis. The relationship between clinical evolution and inflammatory biomarkers in patients with ChikV-induced arthritis has not been fully described. We performed a prospective case series to evaluate the association among joint involvement, self-reported disability, and inflammatory biomarkers. Patients with ChikV infection were followed for 1 year. Joint involvement and self-reported disability were evaluated with disease activity index 28 (DAS-28) and World Health Organization Disablement Assessment Schedule II (WHODAS-II). Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were used as biomarkers. Ten patients with mean age 48 ±15.04 years were included. Symptoms at diagnosis were fever, arthralgias, myalgias, rash, arthritis, nausea, vomiting, and back pain. Polyarticular involvement was present in seven cases. At diagnosis, measures were as follows: DAS-28, 5.08±1.11; WHODAS-II score, 72.3±10.3 %; CRP, 5.09±7.23 mg/dL; ESR, 33.5±17.5 mm/h; RF, 64±21.7 IU/mL; and IL-6, 17.6±10.3 pg/mL. Six patients developed subacute and chronic symptoms. During follow-up, DAS-28 index, WHODAS-II score, ESR, and IL-6 were statistically different in patients with subacute and chronic symptoms compared to those who resolved in the acute phase (p < 0.05). DAS-28 index, WHODAS-II score, and IL-6 were related to chronicity of articular symptoms and could be used as predictors of ChikV-induced arthritis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schwartz O, Albert ML (2010) Biology and pathogenesis of chikungunya virus. Nature. Rev Microbiol 8:491–500
Weaver SC, Lecuit M (2015) Chikungunya virus and the global spread of a mosquito-borne disease. N Engl J Med 37:1231–1239
Kautz TF, Díaz-González EE, Erasmus JH et al (2015) Chikungunya virus as cause of febrile illness outbreak, Chiapas, Mexico, 2014. Emerg Infect Dis 21(11):2070–2073. doi:10.3201/eid2111.150546
Organizacion Panamericana de la Salud (2011). Preparación y respuesta ante la eventual introducción del virus Chikungunya en las Américas. Recovered of http://www1.paho.org/hq/dmdocuments/CHIKV_Spanish.pdf .
Manimunda SP, Vijayachari P, Uppoor R et al (2010) Clinical progression of chikungunya fever during acute and chronic arthritic stages and the changes in joint morphology as revealed by imaging. Trans R Soc Trop Med Hyg 104:392–399
Chen W, Foo SS, Sims NA et al (2015) Arthritogenic alphaviruses: new insights into arthritis and bone pathology. Trends Microbiol 23:35–43
Chow A, Zhisheng H, Ong E et al (2011) Persistent arthralgia induced by chikungunya virus infection is associated with interleukin-6 and granulocyte macrophage colony-stimulating factor. J Infect Dis 203:149–157
Lohachanakul J, Weerawat P, Thannagith M et al (2012) High concentrations of circulating interleukin 6 and monocyte chemotactic protein-1 with low concentrations of interleukin-8 were associated with severe chikungunya fever during the 2009-2010 outbreak in Thailand. Microbiol Immunol 56:134–138
Garin O, Ayuso-Mateos JL, Almansa J et al (2010) Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health Qual Life Outcomes 8:51. doi:10.1186/1477-7525-8-51
Singh JA, Saag KG, Jr SLB et al (2015) American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care& Research. doi:10.1002/acr.22783
Chopra A, Anuradha V, Ghorpade R et al (2012) Acute chikungunya (CHIKV) and persistent musculoskeletal pain following the 2006 Indian epidemic: a two year prospective rural community study. Epidemiol Infect 140:842–850
Rahim AA, Thekkekara RJ, Bina T, Paul BJ (2016) Disability with persistent pain following an epidemic of chikungunya in rural South India. J Rheumatol 43:440–444
Arroyo-Ávila M, Vilá LM (2015) Rheumatic manifestations in patients with chikungunya infection. P R Health Sci J 34:71–77
Rodríguez-Morales AJ, Cardona-Ospina JA, Urbano-Garzón SF, Hurtado-Zapata JS (2016) Prevalence of post-chikungunya chronic inflammatory rheumatism: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). doi:10.1002/acr.22900 Mar 25, [Epub ahead of print]
Hawman DW, Stoermer KA, Montgomery SA et al (2013) Chronic joint disease caused by persistent chikungunya virus infection is controlled by the adaptive immune response. J Virol 87:13878–13888
Venugopalan A, Ghorpade RP, Chopra A (2014) Cytokines in acute chikungunya. PLoS One 9:e111305
Chow A, Her Z, Ong EK et al (2011) Persistent arthralgia induced by chikungunya virus infection is associated with interleukin-6 and granulocyte macrophage colony-stimulating factor. J Infect Dis 203:149–157
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
None.
Rights and permissions
About this article
Cite this article
Sepúlveda-Delgado, J., Vera-Lastra, O.L., Trujillo-Murillo, K. et al. Inflammatory biomarkers, disease activity index, and self-reported disability may be predictors of chronic arthritis after chikungunya infection: brief report. Clin Rheumatol 36, 695–699 (2017). https://doi.org/10.1007/s10067-016-3419-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-016-3419-2