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methotrexate chikungunya

José Kennedy Amaral, Robert T Schoen
INTRODUCTION: Chronic chikungunya (CHIK) arthritis, an inflammatory arthritis, often follows acute CHIK fever (CHIKF), a viral infection. The pathogenesis of chronic CHIK arthritis is poorly characterized, but may resemble other forms of inflammatory arthritis. Clinically, chronic CHIK arthritis sometimes mimics rheumatoid arthritis (RA). CASE REPORT: We report a patient with well-characterized CHIKF followed 2 months later by chronic CHIK arthritis not only resembling RA clinically, but also associated with RA biomarkers and extra-articular features, including Felty's syndrome (FS)...
June 2018: Rheumatology and Therapy
Aileen Y Chang, Jeffrey M Bethony, Gary L Simon, Liliana Encinales
No abstract text is available yet for this article.
March 7, 2018: Arthritis & Rheumatology
Sarah Onuora
No abstract text is available yet for this article.
March 2018: Nature Reviews. Rheumatology
Ravi B Sutaria, Jose K Amaral, Robert T Schoen
PURPOSE OF REVIEW: To review the emergence, clinical features, pathogenesis, and treatment of acute chikungunya (CHIK) fever and chronic CHIK arthritis. RECENT FINDINGS: Since 2004, CHIK, an arboviral infection, has spread throughout the world, infecting millions of people. The illness occurs in two phases: an acute viremic infection followed by chronic arthritis. In less developed countries, there are limited resources and effective treatment. For acutely ill CHIK fever patients, management is symptomatic...
May 2018: Current Opinion in Rheumatology
J Kennedy Amaral, Ravi Sutaria, Robert T Schoen
OBJECTIVES: Chikungunya is a rapidly emerging, global viral infection that can cause chronic, debilitating arthritis that in some ways mimics rheumatoid arthritis. This study evaluated the available evidence of the efficacy and safety of methotrexate (MTX), a therapy widely used in rheumatoid arthritis, in the treatment of chronic chikungunya arthritis. METHODS: A systematic literature search was performed to identify all published trials that evaluated MTX as monotherapy or combination therapy in chronic chikungunya arthritis...
January 23, 2018: Arthritis Care & Research
Vinod Ravindran, George Alias
In a proportion of patients, chikungunya arthritis (CA) might run into a chronic persistent phase. The treatment for this phase is not very clear. In this randomized parallel group open label study of 24 weeks duration, we evaluated the efficacy of DMARD combination in persistent CA. Consecutive 139 patients with persistent CA (persistent arthritis for >1 year after the chikungunya fever either in 2008 or 2009 fulfilling epidemiological criteria for CA) were screened. Of these patients who were already taking hydroxychloroquine (HCQ) and had active arthritis were randomized to receive either fixed-dose combination therapy (methotrexate 15 mg/day, sulfasalazine 1 g/day, and HCQ 400 mg/day) or continue with HCQ 400 mg/day (dose optimized) monotherapy...
June 2017: Clinical Rheumatology
Marie Blettery, Lauren Brunier, Kathleen Polomat, Florence Moinet, Christophe Deligny, Serge Arfi, Georges Jean-Baptiste, Michel De Bandt
OBJECTIVE: To describe chronic chikungunya manifestations seen during the outbreak in the Caribbean from December 2013 to January 2015. METHODS: Patients were seen at our center, the only rheumatology department in Martinique Island, and were examined by a senior rheumatologist using a standard care report form. Chikungunya was diagnosed collectively based on consensus among all clinicians. The median time from onset of acute chikungunya to the first rheumatology consultation was calculated, severity was evaluated based on clinical scales and the degree of joint destruction, and each patient's treatment was recorded...
November 2016: Arthritis & Rheumatology
L Valeyrie-Allanore
Significant advances have been performed in cutaneous adverse reactions leading to primary prevention strategy and implication of new signaling pathways. Histological features of DRESS and methotrexate toxicity are detailed. New emerging infectious agents are reported including Zika Virus, an arbovirus which can be confused with dengue or chikungunya, a new cowpox virus transmitted by domestic cat leading to lymphadenitis, Spirurina type X larva transmitted in Japan by eating raw squid or fish. Malignancies in pemphigus and pemphigoid are emphasized...
December 2015: Annales de Dermatologie et de Vénéréologie
Mariangelí Arroyo-Ávila, Luis M Vilá
Chikungunya virus (CHIKV) infection is a common cause of febrile arthritis. The most common manifestations of acute infection are fever, symmetrical polyarthralgias or polyarthritis, myalgias, and maculopapular rash. Up to 80% of patients may develop musculoskeletal manifestations that persist longer than 3 months, causing impairment in their quality of life. The most common chronic manifestations are persistent or relapsing-remitting polyarthralgias, polyarthritis, and myalgias. Fingers, wrists, knees, ankles, and toes are the most frequently involved, but proximal joints and axial involvement can occur in the chronic stage...
June 2015: Puerto Rico Health Sciences Journal
V Rosario, R Munoz-Louis, T Valdez, S Adames, J Medrano, I Paulino, J Paula, R Alba-Fériz
Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92%) exhibiting symmetric polyarthralgias, 344/514 (67%) arthritis, and 385 (75%) skin rash. The great majority 457...
July 2015: Clinical Rheumatology
Emilie Javelle, Anne Ribera, Isabelle Degasne, Bernard-Alex Gaüzère, Catherine Marimoutou, Fabrice Simon
BACKGROUND: Since 2003, the tropical arthritogenic chikungunya (CHIK) virus has become an increasingly medical and economic burden in affected areas as it can often result in long-term disabilities. The clinical spectrum of post-CHIK (pCHIK) rheumatic disorders is wide. Evidence-based recommendations are needed to help physicians manage the treatment of afflicted patients. PATIENTS AND METHODS: We conducted a 6-year case series retrospective study in Reunion Island of patients referred to a rheumatologist due to continuous rheumatic or musculoskeletal pains that persisted following CHIK infection...
March 2015: PLoS Neglected Tropical Diseases
Adam Taylor, Kuo-Ching Sheng, Lara J Herrero, Weiqiang Chen, Nestor E Rulli, Suresh Mahalingam
Part of the Togaviridae family, alphaviruses, including chikungunya virus (CHIKV), Sindbis virus (SINV) and Ross River virus (RRV), are able to cause significant inflammatory pathologies ranging from arthritis to encephalitis. Following symptomatic infection with arthritis-associated alphaviruses, patients often experience severe joint pain, affecting distal and small joints, which can last six months or longer. Recently, methotrexate (MTX), a disease modifying anti-rheumatic drug (DMARD), was used to treat patients experiencing chronic rheumatic symptoms following infection with CHIKV...
2013: PloS One
F Simon, E Javelle
The chikungunya outbreak on Reunion Island in 2005-2006 was followed by a high incidence of persistent arthralgia. A small group of patients developed chronic, sometimes destructive, post-chikungunya inflammatory rheumatism presenting as rheumatoid polyarthritis or spondylarthritis that required disease-modifying antirheumatic drugs such as methotrexate. We describe two patients under this treatment confronted with financial health insurance issues due to the lack of administrative recognition of post-chikungunya rheumatism as a long-term affliction or an occupational disease...
March 2012: Médecine Tropicale: Revue du Corps de Santé Colonial
A Ribéra, I Degasne, M C Jaffar Bandjee, Ph Gasque
The chikungunya virus epidemic that occurred on Reunion Island from May 2005 to the end of 2006 affected 30% of the population (more than 250 000 people). As a result of its major clinical impact, this outbreak allowed better documentation of the acute phase of the disease. The disease generally has a slowly self-limiting course over a period of several months with rheumatic manifestations. For practitioners, these symptoms raise numerous questions at several levels, i.e., i) role of the virus in pain, ii) most appropriate treatment, and iii) prevention of development of chronic symptoms...
March 2012: Médecine Tropicale: Revue du Corps de Santé Colonial
Mohini A Ganu, A S Ganu
AIM: 1) To study clinical features and laboratory findings in patients of post chikungunya chronic arthritis (PCCA). 2) To study effectivity of disease modifying antirheumatic drugs (DMARDs) in treatment of post-chikungunya chronic arthritis. MATERIALS AND METHODS: Sixteen Chikungunya IgM positive patients having arthritis lasting more than 3 months in spite of NSAIDs and Hydroxychloroquine therapy were selected. Their clinical, laboratory and radiological features were noted...
February 2011: Journal of the Association of Physicians of India
Jean-Jacques Hoarau, Marie-Christine Jaffar Bandjee, Pascale Krejbich Trotot, Trina Das, Ghislaine Li-Pat-Yuen, Bérengère Dassa, Mélanie Denizot, Elsa Guichard, Anne Ribera, Tawfiq Henni, Frank Tallet, Marie Pierre Moiton, Bernard Alex Gauzère, Sandrine Bruniquet, Zaïnoul Jaffar Bandjee, Philippe Morbidelli, Gérard Martigny, Michel Jolivet, Frederick Gay, Marc Grandadam, Hugues Tolou, Vincent Vieillard, Patrice Debré, Brigitte Autran, Philippe Gasque
Alphaviruses, including Chikungunya virus (CHIKV), produce a transient illness in humans, but severe forms leading to chronic incapacitating arthralgia/arthritis have been reported by mechanisms largely ill-characterized. The pathogenesis of CHIKV was addressed in a prospective cohort study of 49 hospitalized patients from Reunion Island subsequently categorized into two distinct groups at 12 mo postinfection. Comprehensive analyses of the clinical and immunological parameters throughout the disease course were analyzed in either the "recovered" or the "chronic" groups to identify prognostic markers of arthritis-like pathology after CHIKV disease...
May 15, 2010: Journal of Immunology: Official Journal of the American Association of Immunologists
Eric Bouquillard, Bernard Combe
OBJECTIVE: In 2005, after an epidemic infection of Chikungunya fever in islands in the Indian Ocean, infected patients exhibited severe musculoskeletal disorders. We report 21 cases of rheumatoid arthritis (RA) after Chikungunya infection that were diagnosed at a rheumatological centre in Reunion Island. METHODS: Patients were examined by the same rheumatologist from February 2006 to July 2007. Inclusion criteria were (1) Chikungunya infection confirmed by IgM and IgG antibodies, (2) RA according to ACR criteria, (3) no other definite diagnosis of arthritis and (4) persistent arthritis symptoms from the onset of viral infection to RA diagnosis...
December 2009: Joint, Bone, Spine: Revue du Rhumatisme
Arvind Chopra, V Anuradha, V Lagoo-Joshi, V Kunjir, S Salvi, M Saluja
No abstract text is available yet for this article.
September 2008: Arthritis and Rheumatism
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