Palabras clave
Virus Chikungunya
Autoinmunidad
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Resumen
Objetivo: Informar un caso de paciente que desarrolló Enfermedad de Still (ES) secundaria a una infección por Chikungunya, revisando diagnósticos diferenciales y posibles interrelaciones. Detalles del caso: Paciente do sexo femenino, 21 años, sin comorbilidades. Presentó fiebre diaria aguda acompañada de poliartralgia incapacitante, exantema evanescente y marcadores inflamatorios elevados tras un episodio febril asociado a una arbovirosis sintomática. La investigación inicial excluyó infecciones comunitarias, con autoanticuerpos negativos y estudios de imagen sin alteraciones. El diagnóstico de ES fue confirmado por criterios clínico-laboratoriales, incluida ferritina > 3000 ng/mL. La serología IgM positiva para Chikungunya indica una relación causal. La paciente mostró buena respuesta a la corticoterapia asociada a metotrexato, con remisión de los síntomas y mejoría funcional progresiva. Consideraciones finales: La ES es una condición inflamatoria rara y desafiante, cuyo diagnóstico depende de la exclusión rigurosa de otras etiologías. Las infecciones virales pueden actuar como desencadenantes inmunológicos. Este informe de caso refuerza la importancia de la sospecha clínica ante síntomas prolongados, el papel del enfoque multidisciplinario y el tratamiento precoz para lograr un buen pronóstico.
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