Rheumatoid Arthritis and Chikungunya
A new study by researchers at Washington University School of Medicine, St. Louis, Missouri has found that symptoms and blood test results of patients with Chikungunya is similar to that of rheumatoid arthritis patients. This implies that it is very important for doctors to obtain detailed travel history and medical history of patients before treating them for rheumatoid arthritis. Patients who has recently travelled to areas where Chikungunya is prevalent (Caribbean, South America, Asia and Africa) must be evaluated for Chikungunya. Sudden high fever and abrupt pain of joints is usually seen only in Chikungunya.
The study was conducted on a group of 10 American travellers who were infected with Chikungunya while on a visit to Haiti in June 2014. Out of these, 8 patients met the criteria for the diagnosis of rheumatoid arthritis. Blood results of Chikungunya and rheumatoid arthritis showed comparable increase in the specialized T cells. Hence chances of misdiagnosing Chikungunya as rheumatoid arthritis is very high. Only specialized blood tests capable of identifying antibodies against Chikungunya can differentiate it from rheumatoid arthritis.
The rapid spread of Chikungunya across the globe indicates the future challenges in proper diagnosis of the disease. In areas where Chikungunya is not well known, there is a very high chance of misdiagnosis and wrong treatment. Chikungunya can also be confused with diseases such as Malaria, Dengue and Leptospirosis.
The study which was published in the January issue of Arthritis and Rheumatology has the following conclusion,
In addition to similar clinical features, patients with CHIKV infection and patients with RA develop very similar peripheral T cell phenotypes. These overlapping clinical and immunologic features highlight a need for rheumatologists to consider CHIKV infection when evaluating patients with new, symmetric polyarthritis.