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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


HERNANDEZ-VALVERDE, Andrea  and  PORRAS, Oscar. Chronic arthritis in a pediatric patient following Chikungunya. Acta méd. costarric [online]. 2020, vol.62, n.3, pp.152-155. ISSN 0001-6002.

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.

Keywords : Chikungunya; chronic arthritis; juvenile idiopathic arthritis; macrophage activation syndrome.

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