Chikungunya among patients with pre-existing rheumatological diseases: are they different from those without prior such diagnoses? a case series

Background: Disease chronicity of chikungunya among patients with pre-existing rheumatological diseases is not well-described in literature. This report describes a series of such cases and compares clinical presentation and disease chronicity with chikungunya patients without prior rheumatological diseases. Methods: Patients’ clinical and laboratory data were recorded in case record forms. They were followed-up for three months for evaluating chronicity. Results: Eight patients (mean age, 40.6 years; male, 6) with different pre-existing rheumatological diseases, complicated by chikungunya virus infection were analyzed. Their clinical presentation included fever (8), joint pain (8), rash (3), pruritus (3) and generalized body ache (4). Two patients (2/8, 25%) entered in chronic phase. When we compared the clinical manifestation and disease chronicity of chikungunya patients with and without prior rheumatological diseases, we found that clinical manifestation (fever, 100% vs 86.9%, p = 0.276; joint pain, 100% vs 88.8%, p = 0.319; rash, 37.5% vs 23.4%, p = 0.372; pruritus, 37.5% vs 15.9%, p = 0.121) were similar but higher percentage of patients of the former group entered in chronic phage (25% vs 9.1%, p = 0.153). Conclusion: In spite of similar initial clinical presentation, higher frequency of patients with pre-existing rheumatological diseases, had post-chikungunya rheumatism.