A Rare Case of Diffuse Polyarthritis in the Context of an Epididymoorchitis due to Mumps Infection

Perreau M,Comte D,Felix N,Lebowitz D,Van Singer M

doi:10.35248/2161-1149.19.9.257

Abstract

Mumps is a childhood disease with declining incidence in the western world and arthritis is a rare complication associated to the disease. Various presentations exist making diagnosis even more challenging. The mechanisms responsible for the joint involvement remain largely unknown but the timing of onset of the symptoms usually coincide with the rise in antibody titers arguing for an immunologic mediated response. We hereby report a rare case of polyarthritis in the onset of epididymoorchitis due to mumps infection in a HIV infected male patient. Elevated IL-6 serum level in our patient suggests that this cytokine may be an interesting biomarker for the diagnosis of mumps related arthritis.

Highlights

Mumps is a childhood disease caused by Myxovirus parotidis, a single stranded RNA virus of the paramyxovirus family [1,2]
Arthritis is a rare complication linked to direct joints damage by the virus or to immune complexes deposition in the joints [8,9] In this paper, we report the case of a patient who developed diffuse polyarthritis in the onset of epididymoorchitis due to mumps infection
We report the case of a HIV infected middle-aged man, originating from Eastern Africa and residing in central Europa who was admitted to hospital for a recent onset of high grade fever, diffuse myalgia, testicular pain and polyarthritis

Summary

INTRODUCTION

Mumps is a childhood disease caused by Myxovirus parotidis, a single stranded RNA virus of the paramyxovirus family [1,2]. Arthritis is a rare complication linked to direct joints damage by the virus or to immune complexes deposition in the joints [8,9] In this paper, we report the case of a patient who developed diffuse polyarthritis in the onset of epididymoorchitis due to mumps infection. Development of polyarthritis in a middle-aged HIV treated patient opens a wide differential diagnosis that includes autoimmune, infectious and crystal joint disorders. To confirm the diagnostic of acute mumps infection, anti-mumps IgG was measured in a frozen sample that was collected one year prior to current investigations and showed an IgG level of 0.04 In light of this clinical workup, we concluded that the patient suffered from a polyarthritis in the onset of an epididymoorchitis related to mumps virus infection. Therapy with glucocorticoid (Prednisolone 20 mg/day, tapered over 2 weeks) was initiated and the patient showed a rapid improvement of symptoms, without recurrence after therapy discontinuation

DISCUSSION

CONCLUSION