RESUMO
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.
RESUMO
Patients with gastroesophageal reflux may have extra-esophageal manifestations. We report a 46 years old ex-smoker woman presenting with a sensation of burning mouth, xerostomia and glossitis. The patient had a history of heartburn, dysphonia and cough. Mouth examination showed a bad hygiene and abundant accumulation of plaque. Esophageal pH measurement was abnormal. Laryngoscopy showed a posterior laryngeal inflammation and mucous secretion. With these data, a diagnosis of gastroesophageal reflux was reached.
Los pacientes con reflujo gastroesofágico pueden tener manifestaciones extra esofágicas. Presentamos una mujer ex fumadora de 46 años que se presentó con sensación de quemazón en la boca, xerostomia y glositis. La paciente tenía además una historia de pirosis retroesternal, disfonía y tos. El examen bucal mostró una mala higiene bucal con abundante acumulación de sarro. Una medición de pH esofágico fue anormal. La laringoscopia mostró una inflamación laríngea posterior y secreción mucosa. Con estos antecedentes se llegó al diagnóstico de reflujo gastroesofágico.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Refluxo Gastroesofágico/complicações , Mucosa Bucal/patologia , Erosão Dentária/patologia , Atrofia , Monitoramento do pH Esofágico , Refluxo Gastroesofágico/patologia , Erosão Dentária/etiologiaRESUMO
Patients with gastroesophageal reflux may have extra-esophageal manifestations. We report a 46 years old ex-smoker woman presenting with a sensation of burning mouth, xerostomia and glossitis. The patient had a history of heartburn, dysphonia and cough. Mouth examination showed a bad hygiene and abundant accumulation of plaque. Esophageal pH measurement was abnormal. Laryngoscopy showed a posterior laryngeal inflammation and mucous secretion. With these data, a diagnosis of gastroesophageal reflux was reached.