Catastrophic Antiphospholipid Syndrome Triggered by Fulminant Chikungunya Infection in a Patient With Systemic Lupus Erythematosus

Betancur, Juan-Felipe; Navarro, Erika P.; Bravo, José Humberto; Cortés, Armando; Vélez, Juan D.; Echeverry, Alex; Suso, Juan-Pablo; Cañas, Carlos A.; Tobón, Gabriel J.

doi:10.1002/art.39580

Cited by 18 publications

(7 citation statements)

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“…Many sources reported arrythmia in general, as well as palpitations [ 15 , 46 , 53 , 76 , 77 ] ( Table 2 and Table 3 ). Additional cardiac alterations included myocardial infarct, heart failure, cardiac arrest, and myocarditis [ 14 , 26 , 29 , 30 , 41 , 43 , 44 , 53 , 61 , 67 , 74 ] ( Table 2 and Table 3 ). In children (ages 1 year to 18 years), the symptoms were similar to that in adults with tachycardia, bradycardia, hypertensive shock, myocarditis, cardiorespiratory failure, and death being reported [ 2 , 34 , 38 , 50 , 52 , 66 , 72 ] ( Table 2 and Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…There are a number of cases in which the CHIKV infection may have aggravated a pre-existing heart condition, including hypertension, ischemic heart disease, cardiac compromise, and heart failure [ 37 , 41 , 44 , 55 , 61 , 70 , 71 , 74 , 79 , 80 ] ( Table 2 and Table 3 ). Additionally, those who are elderly, especially if they have cardiac alterations, were found to be at higher risk of death [ 81 ] ( Table 2 and Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Cardiomyopathy and Death Following Chikungunya Infection: An Increasingly Common Outcome

et al. 2021

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Chikungunya virus (CHIKV) is vectored by Aedes aegypti and Aedes albopictus mosquitoes and is found throughout tropical and sub-tropical regions. While most infections cause mild symptoms such as fever and arthralgia, there have been cases in which cardiac involvement has been reported. In adults, case reports include symptoms ranging from tachycardia and arrythmia, to myocarditis and cardiac arrest. In children, case reports describe symptoms such as arrythmia, myocarditis, and heart failure. Case reports of perinatal and neonatal CHIKV infections have also described cardiovascular compromise, including myocardial hypertrophy, ventricular dysfunction, myocarditis, and death. Myocarditis refers to inflammation of the heart tissue, which can be caused by viral infection, thus becoming viral myocarditis. Since viral myocarditis is linked as a causative factor of other cardiomyopathies, including dilated cardiomyopathy, in which the heart muscle weakens and fails to pump blood properly, the connection between CHIKV and the heart is concerning. We searched Pubmed, Embase, LILACS, and Google Scholar to identify case reports of CHIKV infections where cardiac symptoms were reported. We utilized NCBI Virus and NCBI Nucleotide to explore the lineage/evolution of strains associated with these outbreaks. Statistical analysis was performed to identify which clinical features were associated with death. Phylogenetic analysis determined that CHIKV infections with cardiac symptoms are associated with the Asian, the East Central South African, and the Indian Ocean lineages. Of patients admitted to hospital, death rates ranged from 26–48%. Myocarditis, hypertension, pre-existing conditions, and the development of heart failure were significantly correlated with death. As such, clinicians should be aware in their treatment and follow-up of patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cardiomyopathy and Death Following Chikungunya Infection: An Increasingly Common Outcome

et al. 2021

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“…Mammalian cell receptors known for CHIKV include prohibition (PHB), TIM-1, MXRA8, CD147, lectin DC-SIGN, and ATP synthase subunit and FHL1 (19)(20)(21)(22)(23)(24)(25). Furthermore, other phosphatidylserine-binding proteins, such as Axl, TIM-4 and TIM-1, have also been shown to promote (26)(27)(28)(29)(30) in CHIKV-infected cells. Otherwise, autophagy apoptosis is an important infection mechanism.…”

Section: Pathogenesismentioning

confidence: 99%

The research progress of Chikungunya fever

Cai

Hu²,

Liu³

et al. 2023

Front. Public Health

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Chikungunya fever, an acute infectious disease caused by Chikungunya virus (CHIKV), is transmitted by Aedes aegypti mosquitoes, with fever, rash, and joint pain as the main features. 1952, the first outbreak of Chikungunya fever was in Tanzania, Africa, and the virus was isolated in 1953. The epidemic has expanded from Africa to South Asia, the Indian Ocean islands and the Americas, and is now present in more than 100 countries and territories worldwide, causing approximately 1 million infections worldwide each year. In addition, fatal cases have been reported, making CHIKV a relevant public health disease. The evolution of the virus, globalization, and climate change may have contributed to the spread of CHIKV. 2005–2006 saw the most severe outbreak on Reunion Island, affecting nearly 35% of the population. Since 2005, cases of Chikungunya fever have spread mainly in tropical and subtropical regions, eventually reaching the Americas through the Caribbean island. Today, CHIKV is widely spread worldwide and is a global public health problem. In addition, the lack of a preventive vaccine and approved antiviral treatment makes CHIKV a major global health threat. In this review, we discuss the current knowledge on the pathogenesis of CHIKV, focusing on the atypical disease manifestations. We also provide an updated review of the current development of CHIKV vaccines. Overall, these aspects represent some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development of CHIKV and potential CHIKV vaccines for current development and clinical trials.

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“…Due to the demonstration of risk genotypes for kidney lesions in some individuals, the authors hypothesised that CHIKV may have been a trigger for the onset of kidney lesions especially in those genetically susceptible 50 . Two case reports also support this hypothesis, including a case of acute tubular necrosis due to catastrophic fatal antiphospholipid antibody syndrome in a patient with systemic lupus erythematosus and a case of thrombotic microangiopathy due to atypical haemolytic uraemic syndrome in an individual with increased genetic susceptibility for the disease 51,52 …”

Section: Acute Kidney Injury Associated With Chikungunya Fevermentioning

confidence: 99%

The relationship between chikungunya virus and the kidneys: A scoping review

Costa

Gouveia

Silva

et al. 2022

Reviews in Medical Virology

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Several atypical forms of chikungunya fever (CHIK) have been described, including neurological, cardiac and renal involvement. These forms may be related to high morbidity and mortality rates. This scoping review based on the PubMed, Scopus, and WOS databases aims to identify and summarise all the available evidence regarding the clinical and histopathological presentations and risk factors associated with kidney injury related to CHIK, as well as the clinical impact. Thus, a total of 54 papers were selected from 1606 initial references after applying the defined inclusion criteria. Data on the association between kidney injury and CHIK are scarce, with studies only conducted in the acute phase of the disease, lacking further characterisation. Kidney injury incidence in hospitalised patients using the Kidney Disease Improving Global Outcomes criteria varies from 21% to 45%, being higher among patients with atypical and severe manifestations. Although acute kidney injury does not seem to be related to viraemia, it may be related to higher mortality.Few studies have described the renal histopathological changes in the acute phase of CHIK, with prevalent findings of acute interstitial nephritis with mononuclear infiltrate, glomerular congestion and nephrosclerosis. Only one study assessed the kidney function of patients in the subacute and chronic phases of CHIK. Additionally, individuals with comorbidities, including chronic kidney disease, may be among those with a greater risk of presenting worse outcomes when affected by CHIK. The results described herein may contribute to better understand the relationship between the kidneys and chikungunya virus.

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Catastrophic Antiphospholipid Syndrome Triggered by Fulminant Chikungunya Infection in a Patient With Systemic Lupus Erythematosus

Cited by 18 publications

References 0 publications

Cardiomyopathy and Death Following Chikungunya Infection: An Increasingly Common Outcome

Cardiomyopathy and Death Following Chikungunya Infection: An Increasingly Common Outcome

The research progress of Chikungunya fever

The relationship between chikungunya virus and the kidneys: A scoping review

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