Chikungunya and other viral arthritis.

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-12 DOI:10.1016/j.berh.2025.102068

Arvind Chopra, Anuradha Venugopalan

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引用次数: 0

Abstract

Several viruses cause acute and chronic arthritis. Millions of people suffered from Chikungunya(CHIK) during the recent epidemics/outbreaks in Asia, Africa and the Americas. Almost 20-40 % failed to recover completely and suffered from chronic pain and arthritis sequel. A wide spectrum of clinical phenotypic arthritis was described. Non-specific arthralgias(NSA) and soft tissue pains were predominant although inflammatory arthritis (mostly undifferentiated)(IA-U) was substantial. Specifically, rheumatoid arthritis(RA) and spondyloarthritis(SpA) like disorders were described. The frequency of biomarkers such as rheumatoid factor(RF) was low. Arthritis was mostly non-erosive in population studies. Abnormal immune mechanisms and persistent specific CHIK virus (CHIKV) IgM and IgG antibodies were shown. The etiopathogenetic evidence was divided between intense joint tissue inflammation due to prolonged virus persistence and abnormal autoimmune mechanisms. There was no specific therapy. The symptomatic management was often combined with an empirical use of disease modifying anti rheumatoid drugs and steroids. Substantial research is required to address knowledge gaps and unravel evidence-based medicine.

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基孔肯雅和其他病毒性关节炎。

有几种病毒会引起急性和慢性关节炎。在亚洲、非洲和美洲最近流行/爆发的基孔肯雅热期间，数百万人患有基孔肯雅病。近20- 40%的患者未能完全康复，并伴有慢性疼痛和关节炎后遗症。广泛的临床表型关节炎被描述。非特异性关节痛（NSA）和软组织疼痛是主要的，尽管炎症性关节炎（大多数未分化）（IA-U）是实质性的。具体来说，类风湿关节炎（RA）和脊椎关节炎（SpA）样疾病被描述。类风湿因子（RF）等生物标志物的出现频率较低。在人口研究中，关节炎大多是非糜烂性的。显示了异常的免疫机制和持续特异性的CHIKV IgM和IgG抗体。病因学证据分为两种，一种是由于病毒持续时间长而引起的关节组织剧烈炎症，另一种是自身免疫机制异常。没有特殊的治疗方法。症状管理通常与经验使用疾病改善抗类风湿性药物和类固醇相结合。需要大量的研究来解决知识差距和揭示循证医学。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.