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.