As relações entre a Artropatia Crônica pós-infecção pela Chikungunya e Artrite Reumatoide: revisão sistemática.

Abstract

The relationships between chronic arthropathy post-infection by chikungunya and Rheumatoid arthritis: systematic review. Introduction: Arboviruses are viral infections caused by arboviruses, transmitted to humans through the bite of arthropods, and are the cause of diseases that have been a cause of great concern for public health around the world. Among such arboviruses is chikungunya. This is an acute systemic viral disease, caused by the chikungunya virus, and transmitted by the vectors of the genus Aedes aegypti and Aedes albopictus. It is characterized by high fever, rash, myalgia and severe pain in the joints, affecting mainly the extremities. In certain patients, joint pain or edema may persist for months or even years after the initial infection, characterizing the chronic phase of the disease. Clinical manifestations in acute and chronic infection may resemble some autoimmune diseases such as rheumatoid arthritis, seronegative arthritis, and systemic lupus erythematosus. Rheumatoid arthritis is a chronic autoimmune disease associated with inflammation of the synovial membrane and leading to erosive joint processes. Objective: To identify in the literature, through a systematic review, the possible relationships described between chronic arthropathy caused by chikungunya and rheumatoid arthritis. Methodology: Secondary analysis of data obtained from the systematized search of articles in the LILACS, MEDLINE, PubMed and SciELO databases between the period from 2015 to 2018. Results: Chronic arthropathy was developed in 75.8% of the patients affected by chikungunya. Symmetrical polyarthritis was found in 75% of cases. The main joints were those of the hands, feet, ankles, knees, wrists, proximal interphalangeal and metacarpophalangeal joints. Morning stiffness was observed in 71% of the patients and in 66% there was significant absenteeism of the work functions. Conclusion: Rheumatoid arthritis and chikungunya have a very similar clinic, sharing several pathophysiological aspects, besides possible laboratory and imaging findings. It is important to carry out the differential diagnosis between the two pathologies, which can often be considered a challenge.