Musculoskeletal disorders due to chikungunya virus: A real experience in a rheumatology department in Neiva, Huila

BACKGROUND

Chikungunya (CHIKV), is an endemic RNA virus in some regions of Asia and Africa. In Colombia in 2014, its spread started explosively and quickly. The presentation of CHIKV is a febrile condition, with musculoskeletal symptoms, which can progress to erosive arthropathy and polyarticular deformity. The purpose of this study is to evaluate symptomatic and serological behaviour in patients suffering from CHIKV infection in Neiva, Huila who attend the Rheumatology clinic, and to describe the comorbidities associated with the chronic phase of the disease.

METHODS

An observational, longitudinal and retrospective analysis of data collected in 410 patients afflicted with the CHIKV virus, with symptoms lasting more than 3 months, who persisted with musculoskeletal and joint symptoms. The patients were classified according to their commitment in post-viral arthralgias, polyarthritis post viral, Rheumatoid Arthritis (RA) post CHIKV, Spondyloarthritis postCHIKV, and soft tissue rheumatism. The statistical analysis was performed using SPSS software (version 24). A descriptive analysis was carried out to evaluate quantitative variables such as the mean (standard deviation), and categorical variables such as frequency (%). The categorical variables were compared using the Chi-square equation. As a statistical significance, a p less than .05 was considered.

RESULTS

Of the 410 patients, 89.23% were women, with polyarticular involvement in 92.26% of the cases. Of the patients, 49.83% had osteoarthritis. At the time of the evaluation in the Rheumatology clinic, 46.3% of the cases presented persistent non-inflammatory arthralgias, and 53.7% of the patients underwent arthritis on physical examination, of which, remarkably, 20.3% met the criteria for rheumatoid arthritis postCHIKV.

CONCLUSIONS

The development of musculoskeletal symptoms after CHIKV infection is a very serious public health problem, with persistent complications and long-term morbidity risk in real life. The presence of net postviral arthritis is noteworthy, however the development of postCHIKV rheumatoid arthritis usually requires more advanced pharmacological measures, including, in some cases, transition to biological therapy. The presence of symptoms of venous insufficiency in the lower limbs that developed with CHIKV infection was an incidental finding that requires a more precise study.

Musculoskeletal Disorders due to Chikungunya Virus: A Real Experience in a Rheumatology Department in Neiva, Huila

BACKGROUND

Chikungunya (CHIKV), is an endemic RNA virus in some regions of Asia and Africa. In Colombia in 2014, its spread starts explosively and quickly. The presentation of CHIKV is a febrile condition, with musculoskeletal symptoms, which can progress to erosive arthropathy and polyarticular deformity. The purpose of this study is to evaluate in patients suffering from CHIKV infection in Neiva, Huila who attend the Rheumatology clinic, the symptomatic and serological behavior, and to describe comorbidities associated to the chronic phase of the disease.

METHODS

An observational, longitudinal and retrospective analysis of data collected in 410 patients afflicted with the CHIKV virus, with symptoms lasting more than 3 months, who persisted with musculoskeletal and joint symptoms. The patients were classified according to their commitment in post-viral arthralgias, polyarthritis post viral, Rheumatoid Arthritis (RA) post CHIKV, Spondyloarthritis postCHIKV, and soft tissue rheumatism. The statistical analysis was performed using SPSS software (version 24). A descriptive analysis was carried out to evaluate quantitative variables such as the mean (standard deviation), and categorical variables such as frequency (%). The categorical variables were compared using the Chi-square equation. As a statistical significance, a p less than .05 was considered.

RESULTS

Of the 410 patients, 89.23% were women, with polyarticular involvement in 92.26% of the cases. Of the patients, 49.83% had osteoarthritis. At the time of the evaluation in the Rheumatology clinic, 46.3% of the cases presented persistent non-inflammatory arthralgias, and 53.7% of the patients underwent arthritis on physical examination, of which, remarkably, 20.3% met the criteria for rheumatoid arthritis postCHIKV.

CONCLUSIONS

The development of musculoskeletal symptoms after CHIKV infection is a very serious public health problem, with persistent complications and long-term morbidity risk in real life. The presence of net postviral arthritis is noteworthy, however the development of postCHIKV rheumatoid arthritis usually requires more advanced pharmacological measures, including, in some cases, transition to biological therapy. The presence of symptoms of venous insufficiency in the lower limbs that developed with CHIKV infection was an incidental finding that requires a more precise study.

Abstract B70: Canine Parvovirus-based immunotherapy in breast cancer patients, as coadjuvant treatment to surgery management: 9 years survival following

Introduction: The Cancer Reserch Laboratory (LIC) during the last twenty years generated a product of research to develop a new option therapeutic for the cancer, based in immunotherapy, that decreases them effects side in comparison with them treatments conventional. Previous studies in experimental models in vitro and in vivo with Rathus wistar murinidae showed that it stimulates cell proliferation and reviving the immune system, without evidence of pathophysiological changes or cytotoxicity in the subject of study. Therefore developed the research protocol entitled “The biological CIMT-54 cancer vaccine clinical-therapeutic Protocol”, based on the number of US patent US9.056.070B12 immunotherapy, associated with the use of canine Parvovirus, which involved nine patients diagnosed with breast cancer. The objective of the present study was to evaluate the clinical behavior of patients during nine years of follow-up.

Methodology: A study of retrospective cases that included nine cases of breast cancer who were treated with mastectomy or quadrantectomy which rejected conventional consolidation (chemotherapy and radiation therapy) treatment, and we entered the Protocol for handling with immunotherapy using biological vaccine CIMT-54, the Cancer Research Laboratory in 2007, prior informed consent. The follow-up of each of the cases included the anamnesis of the patient, physical examination, ultrasound, mammography, chest x-rays and lab tests. The collection of the information is obtained from the stories clinical evaluated.

Results: During the year 2007, admitted to the study “Protocol clinical-therapeutic of the vaccine biological ITTA-54 against the cancer”, nine patients with diagnosis of cancer of breast treated previously with mastectomy and in some cases quadrantectomy; all patients received treatment with the biological vaccine CIMT-54 with six doses in the following way: the first three doses of weekly and monthly dose for three months, none presented recurrence locoregional or metastasis during the evaluated period of nine years.

Discussion and Conclusions: Sequentially, the study describes the evolution of the nine patients who were treated with biological vaccine CIMT-54 after surgery, none presented recurrence locoregional or metastasis, during nine years of follow-up, unlike other studies in which post mastectomy initiated processes of radiotherapy or chemotherapy where 6.3% of recurrences have shown In addition to the side effects that can generate this type of conventional treatments. We are still in the process of making molecular analyses more detailed, but is could be considered as an alternative adjuvant to conventional management, without side effects, and proven in the long run.

Citation Format: Hugo Ramiro Segura-Puello, Juan Sebastian Segura-Charry, Ingrid Tatiana Gomez-Martinez, Sandra Viviana Guitarrero-Bustos, Diana Lorena Nieto-Mosquera. Canine Parvovirus-based immunotherapy in breast cancer patients, as coadjuvant treatment to surgery management: 9 years survival following. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2016 Oct 20-23; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2017;5(3 Suppl):Abstract nr B70.