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Review
. 2020 Mar;133(3):e91-e97.
doi: 10.1016/j.amjmed.2019.10.005. Epub 2019 Nov 6.

Chronic Chikungunya Arthritis and Rheumatoid Arthritis: What They Have in Common

J Kennedy Amaral  1 , Joshua B Bilsborrow  2 , Robert T Schoen  2
Affiliations
Review

Chronic Chikungunya Arthritis and Rheumatoid Arthritis: What They Have in Common

J Kennedy Amaral et al. Am J Med. 2020 Mar.

Abstract

Chikungunya virus (CHIKV) is a single-stranded RNA virus belonging to the family Togaviridae and genus Alphavirus that causes an acute febrile illness, chikungunya fever, which is transmitted to humans by Aedes species mosquitoes. During acute illness, patients have high fever, polyarthralgias or polyarthritis, maculopapular rash, headache, and myalgia that lasts for days to weeks. Following resolution of acute infection, a significant proportion of patients develop chronic chikungunya arthritis that can resemble rheumatoid arthritis. In this review, we first consider the historical background of infectious causes of inflammatory arthritis, and then the pathogenic and clinical manifestations of chronic chikungunya arthritis as a rheumatoid arthritis mimic. We believe that chronic chikungunya arthritis may be a postinfectious inflammatory process, and that an understanding of the parallels and differences between chronic chikungunya arthritis and rheumatoid arthritis may offer insights into better diagnosis and treatment of both diseases.

Keywords: Chikungunya; Methotrexate; Pathogeneses; Rheumatoid arthritis; Virus.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Pain scores at W0 and W4 in patients treated with MTX for CCA (as observed data). NRS indicates numerical rating scale.
See this image and copyright information in PMC

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