Inflammatory biomarkers, disease activity index, and self-reported disability may be predictors of chronic arthritis after chikungunya infection: brief report.
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.
Department of Internal Medicine, Hospital Regional de Alta Especialidad Ciudad Salud, Carretera Tapachula-Puerto Madero Km 15 Sin Número Colonia los Toros, Tapachula, Chiapas, Mexico. jesussd52@gmail.com.
J
http://orcid.org/0000-0003-1393-653X
J
Sepúlveda-Delgado
Department of Internal Medicine, Unidad Médica de Alta Especialidad, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico La Raza, IMSS, Mexico City, Mexico.|División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
O L
OL
Vera-Lastra
Research Unit, Hospital Regional de Alta Especialidad, Ciudad Salud, Tapachula, Chiapas, Mexico.
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K
Trujillo-Murillo
Research Unit, Hospital Regional de Alta Especialidad, Ciudad Salud, Tapachula, Chiapas, Mexico.
L M
LM
Canseco-Ávila
Research Unit, Hospital Regional de Alta Especialidad, Ciudad Salud, Tapachula, Chiapas, Mexico.
R A
RA
Sánchez-González
Hospital Regional de Alta Especialidad, Ciudad Salud, Tapachula, Chiapas, Mexico.
O
O
Gómez-Cruz
Mesoamerican Center of Public Health and Disasters (CEMESAD), Autonomous University of Chiapas, Mexico City, Chiapas, Mexico.
A
A
Lugo-Trampe
Regional Center of Investigation in Public Health, Tapachula, Chiapas, Mexico.
I
I
Fernández-Salas
Regional Center of Investigation in Public Health, Tapachula, Chiapas, Mexico.
R
R
Danis-Lozano
Department of Internal Medicine, Hospital Juarez de México, Mexico City, Mexico.
A
A
Contreras-Contreras
Department of Internal Medicine, Hospital Juarez de México, Mexico City, Mexico.
A
A
Mendoza-Torres
Research Unit, Hospital Regional de Alta Especialidad, Ciudad Salud, Tapachula, Chiapas, Mexico.
S
S
Domínguez-Arrevillaga
Department of Internal Medicine, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Chiapas, Mexico.
B A
BA
Mena-Vela
Department of Internal Medicine, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Chiapas, Mexico.
M
M
Ocaña-Sibilla
Department of Internal Medicine, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Chiapas, Mexico.
J C
JC
Ramirez-Valdespino
División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.|Unidad Médica de Alta Especialidad, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Medico La Raza, IMSS, México City, Mexico.
L J
LJ
Jara
D000328:Adult; D000368:Aged; D001168:Arthritis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D065632:Chikungunya Fever / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood*; D057566:Self Report; D012720:Severity of Illness Index
D015415:Biomarkers; D002097:C-Reactive Protein; D012217:Rheumatoid Factor
Chikungunya virus; Chronic arthritis; Disability; Il-6
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