A recent study out of Washington University—involving 10 patients who had traveled to Haiti in 2014 and were found to be positive for the virus—reported that eight of 10 developed arthritis that lasted at least six weeks and that all of them met 2010 ACR/EULAR criteria for RA, showing how difficult this viral illness can be to distinguish from RA.5 RF and CCP tests were negative in all of them.
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July 2015Also By This Author
A mass cytometry analysis of these patients, RA patients and healthy controls found similar NK and T cell profiles in both. But they found differences in the activated T killer cells compared to the healthy controls, and a trend toward higher L-selectin expression in CD4+ T cells in the RA patients.
“These preliminary data suggest that it may be possible to differentiate chronic Chikungunya virus arthritis from early rheumatoid arthritis,” Dr. Jonas said.
“We should be asking patients if they’ve come back from the Caribbean, the U.S. Virgin Islands or other locations where the virus is transmitted. Because the patient may present many weeks or months after their travel, physicians and patients might be not making the connection,” she said. “You have to have a high degree of suspicion.”
Thomas R. Collins is a freelance medical writer based in Florida.
References
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- SEARCH Collaborative Group, Link E, Parish S, et al. SLCO1B1 variants and statin-induced myopathy—A genomewide study. N Engl J Med. 2008 Aug 21;359(8):789–799.
- Werner JL, Christopher-Stine L, Ghazarian SR, et al. Antibody levels correlate with creatine kinase levels and strength in anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase-associated autoimmune myopathy. Arthritis Rheum. 2012 Dec;64(12):4087–4093.
- Chopra A, Anuradha V, Ghorpade R, et al. Acute Chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: A 2-year prospective rural community study. Epidemiol Infect. 2012 May;140(5):842–850.
- Miner JJ, Aw Yeang HX, Fox JM, et al. Brief report: Chikungunya viral arthritis in the United States: A mimic of seronegative rheumatoid arthritis. Arthritis Rheumatol. 2015 May;67(5):1214–1220.