Trombose venosa profunda e vírus chicungunha

Abstract

Some systemic viral infections can be linked to development of deep venous thrombosis and/or pulmonary embolism. This association has already been well described in patients infected by human immunodeficiency virus (HIV), hepatitis C, and influenza. The chikungunya virus is the etiologic agent of chikungunya fever and it has recently been introduced to the American continent. As yet, there is no firm foundation for a relationship between chikungunya and thromboembolism, but the progressive increase in its incidence, the fact that this infection very often causes severe locomotion restrictions due to polyathralgia, and the possibility of direct endothelial injury suggest that cases of venous thromboembolism may begin to be described. In this case report, we describe a patient who developed thrombosis of the right popliteal vein after being admitted for treatment of severe polyathralgia and fever caused by chikungunya virus infection.Keywords: chikungunya virus; chikungunya fever; deep venous thrombosis. ResumoAlgumas infecções virais sistêmicas podem estar relacionadas ao desenvolvimento de trombose venosa profunda e/ou embolia pulmonar. Essa associação já está bem descrita em pacientes com infeções pelo vírus da imunodeficiência humana (HIV), hepatite C ou influenza. Recentemente introduzido no continente americano, o vírus chicungunha, agente etiológico da febre de chicungunha, ainda não tem essa relação bem sedimentada, mas com o aumento progressivo de sua incidência e pelo fato dessa infecção causar, muitas vezes, uma restrição severa da locomoção por poliartralgia e uma possível lesão endotelial direta, casos de tromboembolismo venoso podem começar a ser descritos. Neste relato de caso, descrevemos um paciente que desenvolveu trombose de veia poplítea direita durante internação para tratamento de febre por infecção por vírus chicungunha e poliartralgia severa.Palavras-chave: vírus chicungunha; febre de chicungunha; trombose venosa profunda.

Linfedema secundário de membros e febre chicungunha

“…Chikungunya fever (CF) is caused by the chikungunya virus (CHIKV), an arbovirus of the Alphavirus genus that is transmitted to humans via bites by female mosquitoes of the Aedes genus, and was first described in the 1950s in central Africa and later in other African countries and in Asia. 1 In 2007, CHIKV arrived in Europe, causing a CF outbreak in Italy, and it is believed that from this point onwards dissemination of CHIKV to new territories, such as Australia and the Western hemisphere began to occur. 1,2 In December of 2013, the Pan American Health Organization published the first notification of autochthonous CHIKV transmission on the American continent.…”

“…1 In 2007, CHIKV arrived in Europe, causing a CF outbreak in Italy, and it is believed that from this point onwards dissemination of CHIKV to new territories, such as Australia and the Western hemisphere began to occur. 1,2 In December of 2013, the Pan American Health Organization published the first notification of autochthonous CHIKV transmission on the American continent. 3 Clinically, CF is characterized by abrupt onset of high fever (> 38.9 °C), shivering, and photophobia, lasting approximately 7 days.…”

“…In the majority of cases, patients also develop incapacitating polyathralgia, usually symmetrical, involving hips, elbows, fingers, toes, knees, and ankles, limiting locomotion for months or even years, 1-3 in addition to maculopapular rash on the trunk, face, and extremities, itching, headaches, tiredness, nausea, vomiting, conjunctivitis, cervical lymphadenopathy, and myalgia. [1][2][3] The most common laboratory findings during the acute phase of CF are leukopenia, thrombocytopenia, hypokalemia, and mild to moderate elevation of hepatic transaminases. 1,2 The most common acute clinical complications of CF are secondary to involvement of the central nervous system, such as Guillain-Barré syndrome, and of the vision, including uveitis and retinitis.…”

“…[1][2][3] The most common laboratory findings during the acute phase of CF are leukopenia, thrombocytopenia, hypokalemia, and mild to moderate elevation of hepatic transaminases. 1,2 The most common acute clinical complications of CF are secondary to involvement of the central nervous system, such as Guillain-Barré syndrome, and of the vision, including uveitis and retinitis. 2 Chronically, development of syndromes affecting the joints is common, with long-lasting polyarthritis in 30 to 40% of cases.…”

“…2 Chronically, development of syndromes affecting the joints is common, with long-lasting polyarthritis in 30 to 40% of cases. 1,3 To date, vascular involvement has been described little in the medical literature in relation to CF and is normally restricted to Raynaud's phenomenon persisting beyond the acute phase. 1,2 However, since the CHIKV outbreaks in 2015 and 2016, other vascular manifestations, such as deep venous thrombosis and lymphedema, have also been occasionally described in the medical literature.…”