FRI0438 POST-CHIKUNGUNYA CHRONIC ARTHRITIS - SHARING OF BANGLADESH EXPERIENCE OVER ONE YEAR FOLLOW UP OF 60 PATIENTS

Autor: Sigma Hossain, Surayea Yeasmin, M. M. Hassan, Minhaj Rahim Choudhury, F. Hossain, Md. Ariful Islam
Rok vydání: 2020
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 79:816.1-817
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2020-eular.6101
Popis: Background:Chikungunya virus (CHIKV) infection is an emerging disease which is responsible for several epidemics around the world1. Systematic review and meta-analysis had shown that approximately 25% of cases of Chikungunya(CHIK) would develop CHIK-Chronic Inflammatory Rheumatism and 14% would develop persistent arthritis (or spondylitis)2.Objectives:To describe the frequency of the clinical patterns of chronic arthritis & to characterize the clinical symptoms in a Bangladeshi cohort of CHIK patients 12months post-infection.Methods:In 2017, a Chikungunya outbreak occurred in Dhaka, Bangladesh, during which a prospective cohort of CHIK patients with confirmed diagnosis was constituted. A longitudinal follow up of 60 patients from an initial cohort of 142 patients, attending the out-patient department of Rheumatology, BSMMU, was done. Patients having arthritis/ arthralgia or both lasting more than 3 months were considered as chronic cases. Their baseline and follow-up symptoms at 3m, 6m and 12months were evaluated. Functional status was assessed with the Bengali Version Health Assessment Questionnaire (HAQ).Results:Of the initial 142 patients enrolled in the study, 135(95.1%) had CHIKV-IgM and 29(20.4%) had IgG positive. Patients that followed up in-person were predominantly adult (age 43.73 ± 11.09 years) and female 34 (56.7%). The majority of the patients 35 (58.3%) had undifferentiated arthritis. After three months, 8 (16.3%) had oligoarthralgia, 26 (53.1%) had polyarthralgia and 8 (16.3%) had polyarthralgia with oligoarthritis. At the end of one year, 13 (21.7%) patients underwent complete remission. Among the 47 patients, 21 had joint involvement where 11(52.4%) had polyarthralgia, 5(23.8%) had polyarthralgia with oligoarthritis, 5 (23%) had oligoarthralgia and 4 (19%) had monoarthralgia. Among the 47 patients, mild, moderate and severe functional disability was present in 89.4%, 6.4% and 4.3% patients respectively.Conclusion:After one year of follow up, one-third of the patients remained symptomatic. Polyarthralgia was the predominant clinical feature. Mild functional disability was also observed in a significant number of patients.References:[1]Ali Ou Alla S, Combe B. Arthritis after infection with Chikungunya virus. Best Pract Res Clin Rheumatol. 2011;25(3):337-46.[2]Rodríguez-Morales AJet al.Prevalence of Post-Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis.Arthritis. Care. Res. 68(12), 1849-1858 (2016).Table 1.Socio-demographic and clinical pattern of patients with Chronic CHK arthritis (n=60)Variablesn(%)Age (in years)Mean ±SD43.73 ±11.1SexFemale34 (56.7)Male26 (43.3)First joint involvementGeneralized34 (56.7)Ankle12 (20.0)Knee6 (10.0)Wrist5 (8.3)Others (MTP, shoulder, neck and axial plane)3 (5.0)Clinical patternUndifferentiated35(58.3)Spondyloarthritis10 (16.7)Rheumatoid Arthritis7 (11.7)Pre-existing Spondyloarthritis6(10.2)Pre-existing Rheumatoid Arthritis1(1.7)Pre-existing Osteo-arthritis Arthritis1(1.7)Table 2.Joint involvement of patients with Chronic CHIK arthritisJoint characteristics3 m (n=49)6 m (n=36)1yr (n=21)f(%)f(%)f(%)Type of involvement in persistent painJoint only33 (55.0)28 (46.7)20 (33.3)Both joint & soft-tissue16 (26.7)8 (13.3)1 (1.7)Joint involvementMonoarthralgia1 (2.0)5 (13.9)4 (19.0)Oligoarthralgia8 (16.3)6 (16.7)5 (23.0)Polyarthralgia26 (53.1)18 (50.0)11 (52.4)Monoarthritis1 (2.0)0(0.0)0(0.0)Oligoarthritis6 (12.2)3 (8.3)0(0.0)Polyarthritis7 (14.3)9 (11.1)1 (4.8)Oligoarthralgia & monoarthritis1 (2.0)0 (0.0)0 (0.0)Polyarthralgia & monoarthritis0 (0.0)1 (2.8)0 (0.0)Polyarthralgia & oligoarthritis8 (16.3)4 (11.1)5 (23.8)Polyarthralgia & Polyarthritis1 (2.0)0 (0.0)0 (0)Disclosure of Interests:None declared
Databáze: OpenAIRE
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