ab21210

Prevalence of Sindbis-related (Pogosta) virus infections in patients with arthritis

M. Laine¹, R. Vainionpää², J. Uksila¹, J. Oksi¹, M. Nissilä³, K. Kaarela³, R. Luukkainen⁴, A. Toivanen¹

Departments of Medicine¹, Medical Microbiology¹ and Virology², Turku University, Turku, Rheumatism Foundation Hospital³, Heinola; and Satalinna Hospital⁴, Harjavalta, Finland.

ABSTRACT
Objective
To determine the role of Pogosta virus as a triggering infection in non-specific arthritis.

Methods
Serum samples of 142 patients with acute arthritis were screened for the evidence of Pogosta virus infection. Serological tests for Chlamydia trachomatis, salmonella, parvovirus B19, and Borrelia burgdorferi were also carried out. As verified later, 78 of the patients had rheumatoid arthritis and 63 seronegative poly- or oligoarthritis, while one had systemic lupus erythematosus.

Results
In the early stage of the joint symptoms 4 patients with rheumatoid arthritis, 1 with seronegative polyarthritis and 1 with systemic lupus erythematosus had recent Pogosta virus infection. Four of them had probably had Pogosta disease at the time of the onset of arthritis. In 11 patients with a diagnosis of seronegative arthritis, serological evidence of preceding infection due to salmonella or Chlamydia trachomatis was found, strongly suggesting classical reactive arthritis in these cases.

Conclusions
Our study suggests that also a Sindbis virus infection may be associated both to an acute joint inflammation as a part of Pogosta disease or chronic arthritis. At present, this possibility still needs further research.

Keywords
Pogosta disease, Sindbis virus, rheumatoid arthritis, reactive arthritis.

This study was financially supported by Finnish Rheumatology Research Foundation, Finnish Cultural Foundation, Turku University Foundation and EVO foundation of the Turku University Central Hospital.
Please address correspondence and reprint requests to: Prof. Auli Toivanen, Department of Medicine, Turku University, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
E-mail auli.toivanen@utu.fi