Chikungunya viral arthritis in the United States: A mimic of seronegative rheumatoid arthritis. Miner, J. J.; Aw-Yeang, H.; Fox, J. M.; Taffner, S.; Malkova, O. N.; Oh, S. T.; Kim, A. H.; Diamond, M. S.; Lenschow, D. J.; and Yokoyama, W. M. Arthritis & Rheumatology, 2015.
Chikungunya viral arthritis in the United States: A mimic of seronegative rheumatoid arthritis [link]Paper  doi  abstract   bibtex   
OBJECTIVE: Chikungunya virus (CHIKV) is an arthritogenic mosquito-transmitted alphavirus that spread to the Caribbean in 2013 and the United States in 2014. CHIKV-infected patients develop inflammatory arthritis that can persist for months to years, but little is known about the rheumatologic and immunologic features of CHIKV arthritis in humans, particularly as compared to rheumatoid arthritis (RA). Here, we describe these features in a group of 10 American travelers who were nearly simultaneously infected while visiting Haiti in June 2014. METHODS: Patients were assessed by history, physical examination, and laboratory studies. All patients with CHIKV arthritis had detectable anti-CHIKV IgG. Using cytometry by time of flight (CyTOF), we analyzed peripheral blood mononuclear cells in CHIKV-infected patients, healthy controls, and patients with untreated, active RA. RESULTS: Among ten CHIKV-infected individuals, eight developed persistent symmetric polyarthritis, who otherwise met the 2010 ACR/EULAR criteria for (seronegative) RA. CyTOF analysis revealed that RA and CHIKV-infected patients had greater percentages of activated and effector CD4+ and CD8+ T cells than healthy controls. CONCLUSION: In addition to similar clinical features, patients with CHIKV infection and RA develop highly 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. This article is protected by copyright. All rights reserved.
@article{miner_chikungunya_2015,
	title = {Chikungunya viral arthritis in the {United} {States}: {A} mimic of seronegative rheumatoid arthritis},
	copyright = {{\textcopyright} 2015 American College of Rheumatology},
	issn = {2326-5205},
	shorttitle = {Chikungunya viral arthritis in the {United} {States}},
	url = {http://onlinelibrary.wiley.com/doi/10.1002/art.39027/abstract},
	doi = {10.1002/art.39027},
	abstract = {OBJECTIVE: Chikungunya virus (CHIKV) is an arthritogenic mosquito-transmitted alphavirus that spread to the Caribbean in 2013 and the United States in 2014. CHIKV-infected patients develop inflammatory arthritis that can persist for months to years, but little is known about the rheumatologic and immunologic features of CHIKV arthritis in humans, particularly as compared to rheumatoid arthritis (RA). Here, we describe these features in a group of 10 American travelers who were nearly simultaneously infected while visiting Haiti in June 2014. METHODS: Patients were assessed by history, physical examination, and laboratory studies. All patients with CHIKV arthritis had detectable anti-CHIKV IgG. Using cytometry by time of flight (CyTOF), we analyzed peripheral blood mononuclear cells in CHIKV-infected patients, healthy controls, and patients with untreated, active RA. RESULTS: Among ten CHIKV-infected individuals, eight developed persistent symmetric polyarthritis, who otherwise met the 2010 ACR/EULAR criteria for (seronegative) RA. CyTOF analysis revealed that RA and CHIKV-infected patients had greater percentages of activated and effector CD4+ and CD8+ T cells than healthy controls. CONCLUSION: In addition to similar clinical features, patients with CHIKV infection and RA develop highly 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. This article is protected by copyright. All rights reserved.},
	language = {en},
	urldate = {2015-02-11},
	journal = {Arthritis \& Rheumatology},
	author = {Miner, Jonathan J. and Aw-Yeang, Han-Xian and Fox, Julie M. and Taffner, Samantha and Malkova, Olga N. and Oh, Stephen T. and Kim, Alfred H.J. and Diamond, Michael S. and Lenschow, Deborah J. and Yokoyama, Wayne M.},
	year = {2015},
	pages = {n/a--n/a}
}
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