A new study revealed similar symptoms and tests results in people affected with rheumatoid arthritis and Chikungunya virus, pointing at the importance of accurate diagnosis. Administration of drugs indicated for rheumatoid arthritis in Chikungunya cases could make the condition worse. The researchers noted that medical and travel histories of the patients could help make proper diagnosis.
Chikungunya is caused by a mosquito bite and symptoms include fever and rash, continuing for days. The condition also triggers severe joint pain, lasting for several months or even more than a year in some cases. The Washington University researchers analyzed that similar symptoms are also seen in patients with rheumatoid arthritis, which could lead to misdiagnosis and mistreatment.
Wayne Yokoyama, lead author of the study, said that good travel histories of patients could be the best diagnostic tool. Recent travel to regions where the Chikungunya virus is prevalent should raise suspicions of this infection. Such geographies include the Caribbean, India, Africa and Central and South America. In addition, the disease is accompanied by high fever and abrupt onset of severe joints pain, not generally seen in rheumatoid arthritis.
Similar results shown by test results add more complexity to diagnosis a right condition between Chikungunya and rheumatoid arthritis. High prevalence of Chikungunya virus in the Caribbean and the southern United States also raises concern about increasing infections among Americans.
The researchers also noted that early symptoms are not always pronounced enough to differentiate between rheumatoid arthritis and Chikungunya and similar results from blood tests of these patients increases the diagnostic complexity.
Jonathan Miner, a study author and a rheumatology fellow, explained that all eight patients with Chikungunya-related arthritis met diagnostic criteria for rheumatoid arthritis as outlined by the American College of Rheumatology. Only their recent visit to Haiti helped researchers suspect that they had Chikungunya infections.