Background/Purpose:

Chikungunya (CKV) is a disease caused by an alphavirus, transmitted by mosquitoes of the genus Aedes. Is characterized by arthralgia, myalgia, arthritis and tenosynovitis.¹ Anticyclic citrullinated peptide antibodies (ACPA) are considered specific markers of rheumatoid arthritis (RA). However ACPA have also been detected in patients with other types of chronic inflammatory rheumatism.² The objective of this study is to investigate the positivity of ACPA in post-chikungunya arthritis.

Methods:

This was a ambispective study, cross-sectional, with patients who were taken from the group comprised a total of 514 patients from the register of patients with musculoskeletal post-chikungunya infections in the rheumatology department of the Hospital Docente Padre Billini, from December 2013 to June 2017, ³ patients who met the classification criteria for reactive arthritis.⁴ at the Hospital Docente Padre Bilini, in the period December 2013 – June 2017. Inclusion criteria: Meet the criteria for reactive arthritis. Exclusion criteria: Patients under the age of 18, who have had prior joints symptoms or another diseases that explains the symptoms. ACPA was performed to the patients in the period May – June 2017 and clinical records were reviewed. The program SPSS V23.

Results:

Of a total of 514 patients, 41 patients met the criteria. 90.2% (37) was female, 46-64 years was the most frequent age range. 70.7% (29) had synovitis, of these 29 patients, 75.8% (22) had chronic stage synovitis. At the start of the study 9.7% (4) had positive ACPA and in time seroconversion to 34.1% (14). 24.3% (10) had positive rheumatoid factor (RF). 19.5% (8) had RA according to the 2012 American College of Rheumatology classification criteria for RA, of these 8 patients, the 87.5% (7) had ACPA positive. 2.4% (1) developed an undifferentiated polyarthropathy y 2.4% (1) met criteria for spondyloarthritis with axial and peripheral HLAB27 positive. 14.6% (6) increase C reactive protein and 46.3% (19) increase erythrosedimentation rate. 12.1% (5) were smokers.

Conclusion:

34.1% (14) of 41 patients had ACPA positive over time, of these 14 patients, 57.1% (8) developed ACPA positive RA and 42.8% (6) had positive RF. This demonstrates a relationship between CKV infection arthritis clinics for the first time with musculoskeletal manifestation secondary arthritis and ACPA positivity over time, together with a high risk of developing RA.

References

1. Loreto Horcada, M. Díaz-Calderón, C. Garrido, L. Chikungunya fever. Rheumatic manifestations of an emerging disease in Europe. Reumatol Clin 2015;11:161-4
2. Caterbi, S. Bistoni, O. Alunno, A. et al. Anticyclic Citrullinated Peptide Antibodies in Patients with Rheumatic Diseases other than Rheumatoid Arthritis: Clinical or Pathogenic Significance? J Rheumatol 2015;42;1063-1064
3. V. Rosario, R. Munoz-Louis, T. Valdez, et al. Chikungunya infection in the general population and in patients with rheumatoid arthritis on biological therapy. Clin Rheumatol 2015; 34 (7):1285-7.
4. Sieper, J. Braun, J. Kingsley, G. Report on the fourth International workshop on reactive arthritis. Arthritis Rheum 200;43(4):720-734

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evolution-of-anti-citrullinated-protein-antibodies-in-post-chikungunya-arthritis-patient-in-dominican-republic/