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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...

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Updated: Sep 13, 2025

Multiplexed Isothermal Amplification Based Diagnostic Platform to Detect Zika, Chikungunya, and Dengue 1

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Published on: March 13, 2018

Acute Immunological Biomarkers for Predicting Chronic Rheumatologic Disease After Chikungunya Virus Infection.

Anyela Lozano-Parra¹, Víctor Herrera¹, Luis Ángel Villar²

¹Grupo Epidemiología Clínica, Escuela de Medicina, Universidad Industrial de Santander UIS, Calle 9 Carrera 27, Bucaramanga 680002, Colombia.

Tropical Medicine and Infectious Disease

|July 25, 2025

Summary

Early detection of Chikungunya virus (CHIKV) complications is crucial. Elevated levels of IL-8/CXCL-8, CXCL-9, and CXCL-10 in early CHIKV infection may predict a lower risk of developing chronic rheumatism.

Keywords:

Chikungunya fever biomarkers chemokines chronic rheumatologic disease cytokines

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Area of Science:

Immunology
Virology
Rheumatology

Background:

Chikungunya virus (CHIKV) infection can lead to persistent rheumatological symptoms.
Predictive biomarkers for post-CHIK chronic rheumatism (pCHIK-CR) are needed for early intervention.
Understanding early immune responses is key to managing CHIKV long-term effects.

Purpose of the Study:

To identify early immunological factors that predict the risk of developing pCHIK-CR in adult CHIKV patients.
To assess serum levels of specific cytokines and chemokines during acute and subacute CHIKV infection.
To evaluate the association between these immune markers and the development of chronic rheumatism.

Main Methods:

Nested case-control study involving 46 adult CHIKV-infected patients.
Quantification of serum IL-4, IL-6, IL-8/CXCL-8, IL-27, CCL-2, CXCL-9, CXCL-10, and IgG using Luminex and ELISA.
Piecewise logistic regression analysis adjusted for age and sex to determine associations with pCHIK-CR.

Main Results:

Non-linear associations were observed between IL-8/CXCL-8, CXCL-9, and CXCL-10 levels and pCHIK-CR.
Increased levels of IL-8/CXCL-8, CXCL-9, and CXCL-10 in early CHIKV infection were significantly associated with a reduced risk of pCHIK-CR.
Specific thresholds for these markers (IL-8/CXCL-8 <35.7 pg/mL, CXCL-9 ≥6000 pg/mL, CXCL-10 ≥36,800 pg/mL) indicated a lower risk.

Conclusions:

Elevated early-stage levels of IL-8/CXCL-8, CXCL-9, and CXCL-10 may serve as predictive biomarkers for a lower risk of developing chronic rheumatism after CHIKV infection.
An early and robust immune response, indicated by these markers, might enhance CHIKV control and reduce the likelihood of persistent joint symptoms.
These immune factors show promise as potential biomarkers for assessing chronic rheumatologic disease risk, warranting further validation in larger cohort studies.