Hossain Sigma, Choudhury Minhaj Rahim, Islam Md Ariful, Hassan Md Masudul, Yeasmin Surayea, Hossain Farzana, Zaman Mohammad Mostafa
Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag Avenue, Dhaka, Bangladesh.
Freelance Researcher, Dhaka, Bangladesh.
Trop Med Health. 2022 Mar 8;50(1):21. doi: 10.1186/s41182-022-00412-9.
To identify the clinical patterns and consequences of post-chikungunya arthritis was the study's objective.
This longitudinal study was carried out among 143 Chikungunya virus (CHIKV) infected adult patients at the rheumatology department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during the outbreak of CHIKV infection in 2017. The disease was categorized into three phases: acute or febrile (lasting up to 10 days), subacute (11-90 days), and chronic (> 90 days). Patients who progressed towards the chronic phase were followed up to 1-year. Post-CHIKV de novo chronic inflammatory rheumatisms (CIRs) were characterized by persistent mono or oligoarthritis, undifferentiated polyarthritis, or meet the criteria rheumatoid arthritis (RA) or Spondyloarthritis (SpA). In addition, functional status was assessed by the validated Bangla version of the Health Assessment Questionnaire (HAQ).
Mean age was 43.3 ± 11.5 years, and 51.0% were male. Within 1-year follow-up, 60 (41.9%) patients were suffering from arthralgia/ arthritis. Of them 52 patients did not have any pre-existing arthralgia/arthritis. 35 (65.3%) had undifferentiated arthritis, 10 (19.2%) had SpA, and 7 (13.5%) had RA. Patients with pre-existing rheumatological disorders, 6(4.2%) had SpA, 1(0.7%) had RA and 1(0.7%) had osteoarthritis. Polyarthralgia (n = 33, 55.0%) and polyarthritis (n = 20, 33.3%) were the main presentations. Female gender (OR: 0.45; CI: 0.21-0.96), positive IgG (OR: 0.30; CI: 0.12-0.76), and moderate to severe functional disability (OR: 3.46; CI: 1.62-7.40) were independent predictors of developing chronic post-CHIKV rheumatism.
At 1-year follow-up, more than one-third of the patients remained symptomatic. Female gender, positive IgG, and moderate to severe functional disability contributed to the development of chronicity.
本研究的目的是确定基孔肯雅热后关节炎的临床模式及后果。
这项纵向研究于2017年基孔肯雅病毒（CHIKV）感染疫情期间，在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学（BSMMU）风湿病科对143例感染CHIKV的成年患者进行。该疾病分为三个阶段：急性或发热期（持续长达10天）、亚急性期（11 - 90天）和慢性期（> 90天）。进展至慢性期的患者随访1年。CHIKV感染后新发的慢性炎症性风湿病（CIRs）的特征为持续性单关节炎或寡关节炎、未分化多关节炎，或符合类风湿关节炎（RA）或脊柱关节炎（SpA）的标准。此外，通过经验证的孟加拉语版健康评估问卷（HAQ）评估功能状态。
平均年龄为43.3±11.5岁，男性占51.0%。在1年的随访中，60例（41.9%）患者患有关节痛/关节炎。其中52例患者此前无关节痛/关节炎病史。35例（65.3%）患有未分化关节炎，10例（19.2%）患有SpA，7例（13.5%）患有RA。既往有风湿性疾病的患者中，6例（4.2%）患有SpA，1例（0.7%）患有RA，1例（0.7%）患有骨关节炎。多关节痛（n = 33，55.0%）和多关节炎（n = 20，33.3%）是主要表现。女性（OR：0.45；CI：0.21 - 0.96）、IgG阳性（OR：0.30；CI：0.12 - 0.76）以及中度至重度功能残疾（OR：3.46；CI：1.62 - 7.40）是CHIKV感染后慢性风湿病发生的独立预测因素。
在1年的随访中，超过三分之一的患者仍有症状。女性、IgG阳性以及中度至重度功能残疾是慢性化发展的影响因素。
