Rheumatic fever and its management

Cilliers, Antoinette

doi:10.1136/bmj.39031.420637.be

Cited by 68 publications

(74 citation statements)

References 23 publications

(14 reference statements)

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“…The group A streptococcus group can be subdivided according to more than 130 M-type proteins (2004). Despite major medical progress, the pathogenesis of rheumatic fever is not completely understood (Cilliers 2006). Only 0.3-3% of infected people will developed rheumatic fever, possibly indicating a prior genetic predisposition (2004).…”

Section: Autoimmune Aspectsmentioning

confidence: 99%

“…The major criteria are (a) carditis, (b) polyarthritis, (c) Sydenham's chorea, (d) erythema marginatum, and (e) subcutaneous nodules. The minor criteria are (a) arthralgia, (b) fever, (c) elevated erythrocyte sedimentation rate or C-reactive protein (CRP), and (d) prolonged P-R interval (Table 4) (2004; Carapetis et al 2005;Cilliers 2006;Sherer and Shoenfeld 2008). It has been suggested that carditis should be sought by using routine echocardiography, as its sensitivity is up to 10 times higher than auscultation alone (2004; Sherer and Shoenfeld 2008).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

“…Further research is warranted in order to evaluate the long-term therapeutic effect of corticosteroids and other new anti-inflammatory drugs in the treatment of acute rheumatic fever (2004; Carapetis et al 2005). Corticosteroids are not superior to aspirin, and vice versa, in the prevention of cardiac complication (Cilliers 2006). Intravenous immunoglobulins (IVIg) do not reduce valvulitis or alter the natural history and are therefore not recommended in this setting (Nussinovitch and Shoenfeld 2008a).…”

Section: Therapymentioning

confidence: 99%

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Autoimmunity and heart diseases: pathogenesis and diagnostic criteria

Nussinovitch

Shoenfeld

2009

Arch. Immunol. Ther. Exp.

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Autoimmunity may evolve in predisposed individuals following an exogenous trigger. Autoimmunity is affected by genetic, immune, hormonal, and environmental factors. Immune mechanisms in heart diseases are complex and often not completely understood. Several cardiac disorders are believed to be mediated by an immune reaction. Both humoral and cellular immunity are associated with the development of myocarditis, dilated cardiomyopathy, heart failure, rheumatic fever, and atherosclerosis. Here the diagnostic criteria and autoimmune aspects of autoimmune-mediated cardiac disorders are reviewed. New diagnostic criteria for "autoimmune dilated cardiomyopathy" were recently suggested by the authors. They presume that establishing a dominant autoimmune etiology in some patients will have clinical significance because these patients will potentially gain the greatest benefit from immunosuppressive and immunomodulating treatments.

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Section: Autoimmune Aspectsmentioning

confidence: 99%

Section: Diagnostic Criteriamentioning

confidence: 99%

Section: Therapymentioning

confidence: 99%

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Autoimmunity and heart diseases: pathogenesis and diagnostic criteria

Nussinovitch

Shoenfeld

2009

Arch. Immunol. Ther. Exp.

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“…[1][2][3] Secondary prophylaxis based on monthly penicillin injections in children identified to have evidence of RHD has been shown to be the most efficient and cost-effective strategy to reduce RHD burden. 1,4 -6 Early detection is thus highly desirable, and therefore maximizing case detection of subclinical RHD is of major public health importance in developing countries.…”

mentioning

confidence: 99%

Rheumatic Heart Disease Screening by Echocardiography

et al. 2009

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Background-Early case detection is vital in rheumatic heart disease (RHD) in children to minimize the risk of advanced valvular heart disease by preventive measures. The currently utilized World Health Organization (WHO) criteria for echocardiographic diagnosis of subclinical RHD emphasize the presence of pathological valve regurgitation but do not include valves with morphological features of RHD without pathological regurgitation. We hypothesized that adding morphological features to diagnostic criteria might have significant consequences in terms of case detection rates. Methods and Results-We screened 2170 randomly selected school children aged 6 to 17 years in Maputo, Mozambique, clinically and by a portable ultrasound system. Two different echocardiographic sets of criteria for RHD were assessed: "WHO" (exclusively Doppler-based) and "combined" (Doppler and morphology-based) criteria. Independent investigators reviewed all suspected RHD cases using a higher-resolution, nonportable ultrasound system. On-site echocardiography identified 18 and 124 children with suspected RHD according to WHO and combined criteria, respectively. After consensus review, 17 were finally considered to have definite RHD according to WHO criteria, and 66 had definite RHD according to combined criteria, giving prevalence rates of 7.8 (95% confidence interval, 4.6 to 12.5) and 30.

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“…ARF has extremely variable manifestations and remains a clinical syndrome for which no specific diagnostic test exists. Persons who have experienced an episode of ARF are predisposed to recurrence following subsequent (rheumatogenic) group A streptococcal infections [1]. Despite dramatic falls in the incidence, rheumatic fever is still an endemic disease in developing countries, and it remains a major cause of morbidity and mortality associated with acquired heart disease in developing countries.…”

Section: Introductionmentioning

confidence: 99%

Concurrent Acute Rheumatic Fever and Infective Endocarditis: Case Report

Çetin¹,

Yılmaz²,

Ceylan³

et al. 2015

CRCM

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Acute rheumatic fever (ARF) is an inflammatory disease that occurs following an infection with certain strains of group A beta-hemolytic streptococci. Despite dramatic falls in the incidence, Acute Rheumatic Fever remains a major cause of morbidity and mortality associated with acquired heart disease in developing countries. Infective endocarditis (IE) is defined as a microbial infection of the endothelial surface of the heart. IE occurs most frequently in patients with chronic rheumatic heart disease. As far as we know, the simultaneous occurrence of both conditions has not been previously reported. References to our outpatient clinic with complaints of fever and joint pain, clinical and laboratory findings suggestive of infective endocarditis fits both with both the ARF and remitted entirely with appropriate treatment, as far as we know, we think that this is not a case of our similar event in the literature. Here we present a case of a fifteen-year-old girl with concurrent acute rheumatic fever and infective endocarditis.

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Rheumatic fever and its management

Cited by 68 publications

References 23 publications

Autoimmunity and heart diseases: pathogenesis and diagnostic criteria

Autoimmunity and heart diseases: pathogenesis and diagnostic criteria

Rheumatic Heart Disease Screening by Echocardiography

Concurrent Acute Rheumatic Fever and Infective Endocarditis: Case Report

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