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Clinical features, T cell phenotypes similar in RA, chikungunya
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Patients with the chikungunya virus had similar clinical presentation and T cell counts compared to patients with new, symmetric rheumatoid arthritis, according to recently published research.
Ten patients who returned to the U.S. from Haiti during a similar time period in June 2014 were studied. Eight of the patients developed seronegative, persistent polyarthritis that met American College of Rheumatology/European League Against Rheumatism 2010 criteria for rheumatoid arthritis (RA). Participants ranged in age from 18 years to 57 years and were screened by a rheumatologist between 7 weeks and 10 weeks post-infection. Six patients newly diagnosed with and untreated for RA and four healthy participants were included in the study as controls.
In addition to a comprehensive metabolic panel and other blood tests, blood sera were analyzed for anti-chikungunya IgG antibodies, for which all 10 patients were positive.
No patients had family history of rheumatologic disease and none were positive for rheumatoid factor or anti-citrullinated peptide antibodies. Three patients with chikungunya had positive anti-nuclear antibodies, and two patients had elevated C-reactive protein.
Patients in both groups had similar natural killer cells and T cell profiles. Naïve, activated and effector T killer and helper T cells levels were similar in both patient groups and higher than in controls. The researchers reported that if the travel history of the patients with chikungunya was unknown, all patients met the criteria for RA. Therefore, travel history should be considered in new diagnosis of RA or when re-evaluating a flare in ongoing disease. - by Shirley Pulawski
Disclosures: Miner reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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