Abstract | AIM: MATERIALS AND METHODS: Sixteen Chikungunya IgM positive patients having arthritis lasting more than 3 months in spite of NSAIDs and Hydroxychloroquine therapy were selected. Their clinical, laboratory and radiological features were noted. Disease activity was assessed by clinical parameters and Disease Activity Score System ( DAS 28). Functional status was assessed by HAQ Questionnaire on follow-up visits over next 2 years. Effectivity of treatment with Sulfasalazine and Methotrexate was assessed. RESULTS: Chronic inflammatory polyarthritis does occur following chikungunya infection. It involves large and small joints of hands and feet and is erosive and deforming. It is rheumatoid factor negative. AntiCCP antibody was positive in majority. Synovial biopsy revealed nongranulomatous chronic synovitis with infiltration with lymphocytes and plasma cells. It was negative for chikungunya RNA. Treatment with Sulfasalazine with and without methotrexate produced good response in 71.4 % and 12.5% respectively. CONCLUSIONS: Chronic inflammatory, erosive and rarely deforming polyarthritis does occur after acute chikungunya infection in some (5.6%). It is seronegative and AntiCCP positive in majority. DMARDs like sulfasalazine and methotrexate are required and effective in treatment of PCCA.
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Authors | Mohini A Ganu, A S Ganu |
Journal | The Journal of the Association of Physicians of India
(J Assoc Physicians India)
Vol. 59
Pg. 83-6
(Feb 2011)
ISSN: 0004-5772 [Print] India |
PMID | 21751641
(Publication Type: Journal Article)
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Chemical References |
- Antirheumatic Agents
- Sulfasalazine
- Hydroxychloroquine
- Methotrexate
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Topics |
- Adult
- Aged
- Alphavirus Infections
(complications, diagnosis)
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(drug therapy, virology)
- Chikungunya Fever
- Chikungunya virus
(isolation & purification)
- Chronic Disease
- Drug Therapy, Combination
- Epidemics
- Female
- Follow-Up Studies
- Humans
- Hydroxychloroquine
(therapeutic use)
- Male
- Methotrexate
(therapeutic use)
- Middle Aged
- Severity of Illness Index
- Sulfasalazine
(therapeutic use)
- Treatment Outcome
- Young Adult
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