دورية أكاديمية
Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort.
| العنوان: | Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort. |
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| المؤلفون: | Lázari, CDS, Ramundo, MS, Ten-Caten, F, Bressan, CS, De Filippis, AMB, Manuli, ER, De Moraes, I, Pereira, GM, Côrtes, MF, Candido, DDS, Gerber, AL, Guimarães, AP, Faria, NR, Nakaya, HI, Vasconcelos, ATR, Brasil, P, Paranhos-Baccalà, G, Sabino, EC |
| المصدر: | 17 ; 1 |
| بيانات النشر: | Public Library of Science |
| سنة النشر: | 2022 |
| المجموعة: | Imperial College London: Spiral |
| جغرافية الموضوع: | United States |
| الوصف: | BACKGROUND: Chikungunya-fever (CHIKF) remains a public health major issue. It is clinically divided into three phases: acute, post-acute and chronic. Chronic cases correspond to 25-40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD). We aimed to identify early clinical markers of evolution to pCHIKV-CIJD during acute and post-acute phases. METHODOLOGY/PRINCIPAL FINDINGS: We studied a prospective cohort of CHIKF-confirmed volunteers with longitudinal clinical data collection from symptoms onset up to 90 days, including a 21-day visit (D21). Of 169 patients with CHIKF, 86 (50.9%) completed the follow-up, from whom 39 met clinical criteria for pCHIKV-CIJD (45.3%). The relative risk of chronification was higher in women compared to men (RR = 1.52; 95% CI = 1.15-1.99; FDR = 0.03). None of the symptoms or signs presented at D0 behaved as an early predictor of pCHIKV-CIJD, while being symptomatic at D21 was a risk factor for chronification (RR = 1.31; 95% CI = 1.09-1.55; FDR = 0.03). Significance was also observed for joint pain (RR = 1.35; 95% CI = 1.12-1.61; FDR = 0.02), reported edema (RR = 3.61; 95% CI = 1.44-9.06; FDR = 0.03), reported hand and/or feet small joints edema (RR = 4.22; 95% CI = 1.51-11.78; FDR = 0.02), and peri-articular edema observed during physical examination (RR = 2.89; 95% CI = 1.58-5.28; FDR = 0.002). Furthermore, patients with no findings in physical examination at D21 were at lower risk of chronic evolution (RR = 0.41, 95% CI = 0.24-0.70, FDR = 0.01). Twenty-nine pCHIKV-CIJD patients had abnormal articular ultrasonography (90.6% of the examined). The most common findings were synovitis (65.5%) and joint effusion (58.6%). CONCLUSION: This cohort has provided important insights into the prognostic evaluation of CHIKF. Symptomatic sub-acute disease is a relevant predictor of evolution to chronic arthritis with ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1935-2727 |
| العلاقة: | PLoS Neglected Tropical Diseases; http://hdl.handle.net/10044/1/102261Test |
| DOI: | 10.1371/journal.pntd.0011037 |
| الإتاحة: | https://doi.org/10.1371/journal.pntd.0011037Test http://hdl.handle.net/10044/1/102261Test |
| حقوق: | Copyright: © 2023 Lázari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ; http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.E28C33E |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 19352727 |
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| DOI: | 10.1371/journal.pntd.0011037 |