<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022020000300152</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Artritis crónica en una paciente pediátrica posterior a Chikungunya]]></article-title>
<article-title xml:lang="en"><![CDATA[Chronic arthritis in a pediatric patient following Chikungunya]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Valverde]]></surname>
<given-names><![CDATA[Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Porras]]></surname>
<given-names><![CDATA[Oscar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense de Seguro Social Hospital Nacional de Niños &#8220;Dr. Carlos Sáenz Herrera Servicio de Inmunología y Reumatología Pediátrica]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Notnormalized</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2020</year>
</pub-date>
<volume>62</volume>
<numero>3</numero>
<fpage>152</fpage>
<lpage>155</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022020000300152&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022020000300152&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022020000300152&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El virus Chikungunya produce una enfermedad de reciente aparición y creciente incidencia en Costa Rica. Las manifestaciones crónicas de la enfermedad se consideran de importancia en el área de la reumatología. La paciente presentó factores de riesgo para cronicidad como el sexo, la duración y severidad de la fase aguda, el número de articulaciones comprometidas y la asociación con el síndrome de activación macrofágica. En una artritis idiopática juvenil, que es el principal diagnóstico diferencial, se esperaría un inicio más insidioso y no agudo como en este caso; además, la paciente no presentó hepatomegalia o serositis e inicialmente no tuvo trombocitosis, pero manifestó un síndrome de activación macrofágica, que es una complicación inflamatoria descrita en artritis idiopática juvenil. La remisión del cuadro de artritis crónica con el uso de metotrexate, no ayuda al diagnóstico diferencial, porque se ha reportado que este es el tratamiento crónico de elección en ambas patologías. En este reporte se presenta el caso de una paciente pediátrica que ingresó con un cuadro agudo de Chikungunya confirmado serológicamente, y que evolucionó con criterios de una artritis idiopática juvenil sistémica y un síndrome de activación macrofágica secundario.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Chikungunya virus produce a disease of recent emergence and increasing incidence in Costa Rica. Chronicmanifestations of the disease are considered of importance in the rheumatology area. The patient presented risk factors for chronicity such as sex, the duration and severity of the acute phase, the number of joints involved, and the association with macrophage activation syndrome. In juvenile idiopathic arthritis, which is the main differential diagnosis, a more insidious and non-acute onset would be expected, as in this case, in addition, the patient did not present hepatomegaly or serositis and initially did not have thrombocytosis, but had a macrophage activation syndrome, which is an inflammatory complication described in juvenile idiopathic arthritis. Remission of the chronic arthritis condition with the use of methotrexate does not help the differential diagnosis, because it has been reported that this is the chronic treatment of choice in both pathologies. This report presents the case of a pediatric patient who was admitted with an acute episode of Chikungunya confirmed serologically and who evolved with systemic juvenile idiopathic arthritis criteria and secondary macrophage activation syndrome.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[artritis crónica]]></kwd>
<kwd lng="es"><![CDATA[artritis idiopática juvenil]]></kwd>
<kwd lng="es"><![CDATA[síndrome de activación macrofágica]]></kwd>
<kwd lng="en"><![CDATA[Chikungunya]]></kwd>
<kwd lng="en"><![CDATA[chronic arthritis]]></kwd>
<kwd lng="en"><![CDATA[juvenile idiopathic arthritis]]></kwd>
<kwd lng="en"><![CDATA[macrophage activation syndrome]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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