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de Carvalho JF, Kanduc D, da Silva FF, et al. Sjögren's Syndrome Associated with Chikungunya Infection: A Case Report. Rheumatol Ther. 2021;8(1):631-637doi: 10.1007/s40744-021-00281-4.
de Carvalho, J. F., Kanduc, D., da Silva, F. F., Tanay, A., Lucchese, A., & Shoenfeld, Y. (2021). Sjögren's Syndrome Associated with Chikungunya Infection: A Case Report. Rheumatology and therapy, 8(1), 631-637. https://doi.org/10.1007/s40744-021-00281-4
de Carvalho, Jozélio Freire, et al. "Sjögren's Syndrome Associated with Chikungunya Infection: A Case Report." Rheumatology and therapy vol. 8,1 (2021): 631-637. doi: https://doi.org/10.1007/s40744-021-00281-4
de Carvalho JF, Kanduc D, da Silva FF, Tanay A, Lucchese A, Shoenfeld Y. Sjögren's Syndrome Associated with Chikungunya Infection: A Case Report. Rheumatol Ther. 2021 Mar;8(1):631-637. doi: 10.1007/s40744-021-00281-4. Epub 2021 Feb 01. PMID: 33527325; PMCID: PMC7991050.
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Rheumatol Ther. 2021 Mar;8(1):631-637. doi: 10.1007/s40744-021-00281-4. Epub 2021 Feb 01.

Sjögren's Syndrome Associated with Chikungunya Infection: A Case Report.

Rheumatology and therapy

Jozélio Freire de Carvalho, Darja Kanduc, Felipe Freire da Silva, Amir Tanay, Alberta Lucchese, Yehuda Shoenfeld

Affiliations

  1. Institute for Health Sciences from Federal University of Bahia, Salvador, Bahia, Brazil. [email protected].
  2. Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, Bari, Italy.
  3. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
  4. The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  5. Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania 'Luigi Vanvitelli', Naples, Italy.
  6. Chaim Sheba Medical Center, The Zabludowicz Center for Autoimmune Diseases, Tel Hashomer, Israel.
  7. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

PMID: 33527325 PMCID: PMC7991050 DOI: 10.1007/s40744-021-00281-4

Abstract

Chikungunya virus (CHIKV) infection is caused by an arbovirus prevalent in various parts of the world. The virus can induce autoantibodies and rheumatic diseases, such as rheumatoid arthritis and spondylarthritis. However, until now, no case of Sjögren syndrome (SS) was described associated with CHIKV. In this article, we describe a 49-year-old female with polyarthralgia and a temporary rash on her trunk and arms. Her physical examination showed polyarthritis of her ankles and wrists. Serologies for CHIKV were interpreted as positive with IgM 6.5 (normal range < 0.8) and negative for IgG. Antinuclear antibodies were positive at a titer of 1:640 as well as anti-Ro/SS-A. The diagnosis of subacute CHIKV infection was determined. The Schirmer test, Rose Bengal, and salivary scintigraphy were positive and the diagnosis of SS was confirmed. She was treated with hydroxychloroquine, methotrexate, and a single dose of betamethasone depot. This is the first report on CHIKV associated with SS. Sequence analysis of the CHIKV proteome versus SS autoantigens showed an extensive peptide sharing between the virus and numerous SS autoantigens, thus supporting the hypothesis that autoimmune cross-reactivity might causally link CHIKV to SS.

Keywords: Arboviruses; Autoantibodies; Autoimmunity; Chikungunya infection; Molecular mimicry; Sjögren syndrome

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