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OP0111 Arthritis secondary to epstein-barr virus: An infrequent reality
  1. M. Fernández Matilla,
  2. C.M. Feced-Olmos,
  3. J.J. Alegre Sancho,
  4. D. Ybáñez García,
  5. M.A. Martínez Ferrer,
  6. E. Valls Pascual,
  7. M. Robustillo Villarino,
  8. I. de la Morena-Barrio
  1. Rheumatology Section, Hospital Universitario Dr. Peset, Valencia, Spain

Abstract

Background Viral infections can cause inflammatory joint manifestations. Wide series regarding B19 Parvovirus have been published, but the arthritis secondary to Epstein - Barr virus (A-EBV), however, is infrequent and usually presents with multiple joint involvement during a systemic infection.

Objectives To describe the epidemiological characteristics, clinical presentation and evolution of a series of patients with A-EBV.

Methods Descriptive study of A-EBV cases diagnosed in our hospital in a 6-month period. In all cases, serological demonstration of EBV-IgM allowed us to confirm a recent viral infection. Clinical notes were reviewed to collect data in the virus presentation.

Results Case 1: 27-year old woman with a 3-week history of progressive and asymmetrical oligoarthritis involving small joints and high levels of acute phase reactants. Treated with NSAIDs and corticosteroids. Clinical resolution within 3 months, with EBV-IgM clearance. Case 2: 54-year old woman with a 3-week history of progressive and symmetrical small joint polyarthritis. Treated with NSAIDs and corticosteroids. Persistence of symptoms, without EBV-IgM clearance, in spite of DMARD introduction. Case3: 32-year old woman with a 2-month history of progressive and symmetrical small joint polyarthritis, in association with a flu-like syndrome. Needed DMARDs because of the persistence of symptoms. EBV-IgM clearance within 5 months. Case 4: 37-year old woman with a 5-day evolution inflammatory polyarthralgia, associated with erythema, hypertransaminasemia and elevated acute phase reactants. Clinical resolution within 2 weeks. Awaiting check on EBV-IgM clearance.

Conclusions A-EBV seems to affect young women preferably, with a seasonal predominance. It is not infrequent to find chronicity, which is associated with delay in specialist attendance. Given the possible relationship between Epstein-Barr virus and Rheumatoid Arthritis, we should not delay a DMARD treatment in those patients who develop chronic disease.

Disclosure of Interest None Declared

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