Inflammatory biomarkers, disease activity index, and self-reported disability may be predictors of chronic arthritis after chikungunya infection: brief report

Clin Rheumatol. 2017 Mar;36(3):695-699. doi: 10.1007/s10067-016-3419-2. Epub 2016 Sep 28.

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.

Keywords: Chikungunya virus; Chronic arthritis; Disability; Il-6.

MeSH terms

  • Adult
  • Aged
  • Arthritis / blood
  • Arthritis / diagnosis
  • Arthritis / etiology*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Chikungunya Fever / blood
  • Chikungunya Fever / complications*
  • Female
  • Humans
  • Inflammation / blood*
  • Male
  • Middle Aged
  • Prospective Studies
  • Rheumatoid Factor / blood*
  • Self Report
  • Severity of Illness Index

Substances

  • Biomarkers
  • C-Reactive Protein
  • Rheumatoid Factor