Arthritis

Updated 19 November 2015

Chikungunya symptoms can mimic rheumatoid arthritis

Diagnosing chikungunya can be difficult as the mosquito-borne virus mimics symptoms of rheumatoid arthritis.

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Chikungunya has spread in parts of the Caribbean and Central and South America. Though still rare, the virus is increasingly being seen in the United States, according to the researchers.

Adding to the potential confusion in making a diagnosis, the researchers also found that blood tests of patients with chikungunya can have similar results to people with rheumatoid arthritis.

In many people, chikungunya infection causes fever, rash, and joint pain in the hands, feet, knees, neck and elbows. The fever and rash typically ease in seven to 10 days. But joint pain lasts for 12 to 15 months in up to 60 percent of patients. In some patients, joint pain lasts for up to three years, according to the researchers.

Read: Symptoms of rheumatoid arthritis

The study included 10 St. Louis-area residents who were infected with the chikungunya virus during a 2014 trip to Haiti. They were evaluated seven to 10 weeks after symptoms began and compared with people who had rheumatoid arthritis.

Eight of these patients developed persistent arthritis, according to the researchers at Washington University School of Medicine in St. Louis.

"All eight patients with chikungunya-related arthritis met the American College of Rheumatology's criteria for a diagnosis of rheumatoid arthritis," said the study's lead author, Dr. Jonathan Miner, in a university news release.

The study was published recently in Arthritis and Rheumatology.

Read: Warning of mosquito virus gripping travellers

The chikungunya virus was first identified 60 years ago in Africa and has since spread to other parts of the world. According to the U.S. Centres for Disease Control and Prevention, more than 2,000 people in the United States were diagnosed with chikungunya infection in 2014 after travelling to other countries, mostly the Caribbean.

That same year, the CDC reported 11 cases of chikungunya among people living in Florida who had not travelled outside of the country, suggesting that mosquitoes in the state were spreading the virus.

The findings about the similarities between patients with chikungunya infection and rheumatoid arthritis show the need for doctors to get detailed travel and medical histories from patients, the researchers noted.

"For now, good travel histories of patients are among the best diagnostic tools for physicians," study senior author Dr. Wayne Yokoyama, a professor of medicine at the university, said in the news release.

"Recent travel to the Caribbean, Central and South America, Africa, India or other areas where the virus is prevalent should raise suspicions of chikungunya infection. In addition, the disease typically starts with high fever and abrupt onset of severe pain in the joints, which are not usually seen with rheumatoid arthritis," he explained.

Read more:

Weight a factor in rheumatoid arthritis remission

Lower drug doses may keep rheumatoid arthritis at bay


 

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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