Ferritin, Erythrocyte Sedimentation Rate, and C-Reactive Protein Level in Patients with Chikungunya-Induced Chronic Polyarthritis

• Published in: The American journal of tropical medicine and hygiene Vol. 103; no. 5; pp. 2077 - 2082
• Main Authors: Anna Genaro, Maira Sant, Marchi, Micheli Said de, Perin, Matheus Yung, Cossô, Isabelle Silva, Dezengrini Slhessarenko, Renata
• Format: Journal Article
• Language: English
• Published: United States Institute of Tropical Medicine 01-11-2020; The American Society of Tropical Medicine and Hygiene
• Subjects: Adult; Arthritis; Arthritis - etiology; Biomarkers; Biomarkers - metabolism; Blood Sedimentation; C-Reactive Protein - metabolism; Chikungunya Fever - complications; Chikungunya Fever - virology; Chikungunya virus; Cross-Sectional Studies; Erythrocytes; Erythrocytes - metabolism; Female; Ferritins - metabolism; Humans; Iron; Male; Middle Aged; Proteins; Viral infections; Viruses
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.20-0066

Chikungunya virus (CHIKV) is a global emergent arthritogenic alphavirus transmitted by anthropophilic
mosquitoes. Chikungunya fever may evolve to chronic arthralgia in 57-80% of infected patients. This study was developed to identify possibly fast, simple low-cost biomarkers to monitor chronic CHIKV-induced articular disease. Between 2017 and 2018, we analyzed clinical data of patients meeting the criteria established by standard protocols to define chronic chikungunya articular disease. Patients were classified according to the disease activity scores, inflammatory biomarkers (erythrocyte sedimentation rate [ESR], ferritin, and C-reactive protein [CRP] serum), positive rheumatoid factor, comorbidities, smoking, and previous use of corticosteroids determined before beginning therapy. Of 106 patients, 98 (92.5%) were women with mean age of 52 ± 13 years, 6.8 ± 4.4 months of illness duration at the first medical appointment, and 6.7 ± 4.5 affected joints. Mean ESR (26 ± 19), CRP (2.6 ± 3.6), and stratified ferritin (144 ± 115) levels were normal according to reference values. There was no significance in comparing the levels of inflammatory biomarkers and the additional variables analyzed in the presence of moderate chronic joint disease in the study population. However, we identified a negative correlation between disease activity measures and duration of disease at the first medical evaluation after initial infection (
< 0.001), corroborating data observed in the literature.