Sales Gabriella Maria Pitt Gameiro, Barbosa Izabel Crystine Pereira, Canejo Neta Laura Maia Sampaio, Melo Paloma Lopes de, Leitão Raphael de Azevedo, Melo Hugo Moura de Albuquerque
Medical Student, Universidade Federal de Pernambuco (UFPE), Caruaru, PE, Brazil.
MD, Geriatrician, MSc in Palliative Care, and Assistant Professor at UFPE, Caruaru, PE, Brazil.
Rev Assoc Med Bras (1992). 2018 Jan;64(1):63-70. doi: 10.1590/1806-9282.64.01.63.
Chikungunya (CHIK) is a tropical arbovirus, transmitted by the female mosquito Aedes aegypti and Aedes albopictus. In Brazil, there have been cases reported since 2014. The initial manifestations of this virus are sudden onset high fever, headache, chills, rashes, myalgia and intense joint pain. Usually, CHIK presents the acute and chronic phases, the latter characterized by bilateral polyarthralgia, which can last for months or even years. During this period, autoimmune diseases can be triggered, making the picture even more complicated.
A systematic review was performed on the PubMed and Scielo databases in January 2017. Clinical trials, cohorts, case-control and case reports were included in the study. Expert opinions, societal consensuses and literary reviews were exclusion criteria. Studies were conducted in English, Spanish and Portuguese. The studies were descriptively analyzed and the data was grouped according to methodological similarity.
Twenty-four (24) articles were selected and, in compliance with the inclusion and exclusion criteria, 18 were eliminated, with six studies remaining in the present review: five clinical trials and one case report.
When the manifestations of CHIK become chronic and, the longer they last, more complications arise. Polyarthralgia can be immaterial, distancing individuals from their daily-life activities. Anti-inflammatory drugs (either steroid or not), in addition to immunosuppressants, homeopathy and physiotherapy are measures of treatment that, according to the literature, have been successful in relieving or extinguishing symptoms. However, it is fundamental that studies of CHIK treatment be further developed.
基孔肯雅热(CHIK)是一种热带虫媒病毒,由雌性埃及伊蚊和白纹伊蚊传播。自2014年以来,巴西已有病例报告。该病毒的初始表现为突然高热、头痛、寒战、皮疹、肌痛和剧烈关节疼痛。通常,基孔肯雅热有急性期和慢性期,后者的特征是双侧多关节疼痛,可持续数月甚至数年。在此期间,可能引发自身免疫性疾病,使病情更加复杂。
2017年1月在PubMed和Scielo数据库上进行了系统评价。纳入研究的有临床试验、队列研究、病例对照研究和病例报告。专家意见、社会共识和文献综述为排除标准。研究以英文、西班牙文和葡萄牙文进行。对研究进行描述性分析,并根据方法学相似性对数据进行分组。
筛选出24篇文章,根据纳入和排除标准,排除18篇,本综述保留6项研究:5项临床试验和1例病例报告。
当基孔肯雅热的表现转为慢性时,持续时间越长,出现的并发症就越多。多关节疼痛可能无关紧要,但会使患者无法进行日常活动。根据文献,除免疫抑制剂、顺势疗法和物理治疗外,使用抗炎药物(无论是否为类固醇)是成功缓解或消除症状的治疗措施。然而,进一步开展基孔肯雅热治疗研究至关重要。