Girão E S, Rodrigues Dos Santos B G, do Amaral E S, Costa P E G, Pereira K B, de Araujo Filho A H, Hyppolito E B, Mota M U, Marques L C B F, Costa de Oliveira C M, da Silva S L, Garcia J H P, Fernandes P F C B C
Kidney Transplant Unit, Hospital Universitário Walter Cantídio - Fortaleza, Ceará, Brazil; Liver Transplant Unit, Hospital Universitário Walter Cantídio - Fortaleza, Ceará, Brazil.
Kidney Transplant Unit, Hospital Universitário Walter Cantídio - Fortaleza, Ceará, Brazil.
Transplant Proc. 2017 Nov;49(9):2076-2081. doi: 10.1016/j.transproceed.2017.07.004.
Chikungunya virus (CHIKV) is an emerging mosquito-borne disease that causes acute febrile polyarthralgia and arthritis. CHIKV has spread rapidly to the Americas and, in Brazil, autochthonous cases are increasingly been reported. Solid organ transplant (SOT) recipients who travel to or live in CHIKV endemic areas are under high risk of acquiring the disease. Few data exist regarding the clinical characteristics of CHIKV infections in this population. We report the first case series of CHIKV infection in SOT recipients.
We retrospectively evaluated 13 cases of CHIKV infection in SOT recipients between January 2016 and December 2016 confirmed by laboratory tests and transplanted in the Renal and Liver Transplant Units of Walter Cantídio University Hospital from Federal University of Ceará.
Positive CHIKV serology (enzyme-linked immunosorbent assay immunoglobulin M) was found in all patients (9 kidney and 4 liver transplant recipients). All of these patients had been living in endemic areas for dengue and CHIKV in the past months before the illness. The mean time between transplantation and CHIKV infection was of 7.2 years. Fever presented in 11 (84.6%) patients and 5 (38.5%) presented with a maculopapular rash. All cases had joint symptoms: 11 (84.6%) with symmetrical and peripheral polyarthralgia/polyarthritis and 2 (15.3%) with monoarthralgia/monoarthritis. Six (46%) patients had a joint complaint that lasted 3 months. Two patients had concomitant positive dengue serology (enzyme-linked immunosorbent assay immunoglobulin M). There were no cases of complications or deaths.
SOT with CHIKV infection seems to have a clinical presentation and evolution similar to those seen in the general population, with no apparent damage to the graft.
基孔肯雅病毒(CHIKV)是一种新出现的蚊媒疾病,可引起急性发热性多关节痛和关节炎。CHIKV已迅速传播至美洲,在巴西,本土病例报告日益增多。前往或居住在CHIKV流行地区的实体器官移植(SOT)受者感染该疾病的风险很高。关于该人群中CHIKV感染的临床特征的数据很少。我们报告了SOT受者中首例CHIKV感染病例系列。
我们回顾性评估了2016年1月至2016年12月期间在塞阿拉联邦大学沃尔特·坎蒂迪奥大学医院肾移植和肝移植科接受移植且经实验室检查确诊的13例SOT受者CHIKV感染病例。
所有患者(9例肾移植受者和4例肝移植受者)的CHIKV血清学检测(酶联免疫吸附测定免疫球蛋白M)均呈阳性。所有这些患者在发病前的过去几个月里一直生活在登革热和CHIKV的流行地区。移植与CHIKV感染之间的平均时间为7.2年。11例(84.6%)患者出现发热,5例(38.5%)出现斑丘疹。所有病例均有关节症状:11例(84.6%)为对称性外周多关节痛/多关节炎,2例(15.3%)为单关节痛/单关节炎。6例(46%)患者的关节症状持续了3个月。2例患者登革热血清学检测(酶联免疫吸附测定免疫球蛋白M)同时呈阳性。无并发症或死亡病例。
SOT受者感染CHIKV后的临床表现和病程似乎与普通人群相似,对移植物无明显损害。