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Papers of the Week

2020 Mar

Am J Med



Chronic chikungunya arthritis and rheumatoid arthritis: what they have in common.


Amaral KJ, Bilsborrow JB, Schoen RT
Am J Med. 2020 Mar; 133(3):e91-e97.
PMID: 31705850.


Chikungunya virus (CHIKV) is a single-stranded RNA virus belonging to the family Togaviridae and genus Alphavirus, that causes an acute febrile illness, chikungunya fever, transmitted to humans by Aedes species mosquitoes. During acute illness, patients have high fever, polyarthralgias/polyarthritis, maculopapular rash, headache, and myalgia that lasts for days to weeks. Following resolution of acute infection, a significant proportion of patients develop chronic chikungunya arthritis that can resemble rheumatoid arthritis. In this review, we first consider the historical background of infectious causes of inflammatory arthritis, and then the pathogenic and clinical manifestations of chronic chikungunya arthritis as an rheumatoid arthritis mimic. We believe that chronic chikungunya arthritis may be a post-infectious, inflammatory process and that an understanding of the parallels and differences between chronic chikungunya arthritis and rheumatoid arthritis may offer insights into better diagnosis and treatment of both diseases.