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Rheumatic heart disease carditis

Breno Álvares de Faria Pereira, Alinne Rodrigues Belo, Nilzio Antônio da Silva
Rheumatic fever is still currently a prevalent disease, especially in developing countries. Triggered by a Group A β-hemolytic Streptococcus infection, the disease may affect genetically predisposed patients. Rheumatic carditis is the most important of its clinical manifestations, which can generate incapacitating sequelae of great impact for the individual and for society. Currently, its diagnosis is made based on the Jones Criteria, established in 1992 by the American Heart Association (AHA). In 2015, the AHA carried out a significant review of these criteria, with new diagnostic parameters and recommendations...
March 6, 2017: Revista Brasileira de Reumatologia
Taran Kaur Nandra, Nigel J Wilson, John Artrip, Bruno Pagis
Rheumatic heart disease (RHD) has a worldwide prevalence of 33 million cases and 270 000 deaths annually, making it the most common acquired heart disease in the world. There is a disparate global burden in developing countries. This case report aims to address the minimal RHD coverage by the international medical community. A Tahitian boy aged 10 years was diagnosed with advanced heart failure secondary to RHD at a local clinic. Previous, subtle symptoms of changes in handwriting and months of fever had gone unrecognised...
March 10, 2017: BMJ Case Reports
Urška Kočevar, Nataša Toplak, Blaž Kosmač, Luka Kopač, Samo Vesel, Natalija Krajnc, Matjaž Homan, Rina Rus, Tadej Avčin
A decline in the incidence of acute rheumatic fever (ARF) in developed countries over the past century can be attributed to the improved public hygiene and to widespread use of antibiotics. ARF seemed to be a rare disease in southern central European country, Slovenia, up to 2010 when we noticed an increase in the number of patients with ARF. In order to assess the current incidence of ARF, we performed a retrospective study of all patients with ARF treated at the University Children's Hospital Ljubljana from January 2008 until the end of December 2014...
January 2017: European Journal of Pediatrics
Pedro M Azevedo, Tony R Merriman, Ruth K Topless, Nigel J Wilson, Sue Crengle, Diana R Lennon
INTRODUCTION: Rheumatic fever (RF) incidence among New Zealand (NZ) individuals of Polynesian (Māori and Pacific) ancestry remains among the highest in the world. Polymorphisms in the IL-6, IL1RN, and CTLA4 genes have been associated with RF, and their products are modulated by new medications. Confirmation of these previous associations could help guide clinical approaches. We aimed to test IL-6, IL-1RA (IL1RN), and CTLA4 functional SNPs in 204 rheumatic heart disease (RHD) patients and 116 controls of Māori and Pacific ancestry...
September 2016: Cytokine
Ayşe Güler Eroğlu
In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38...
March 2016: Türk Pediatri Arşivi
Najwa Jawhar, Imad Chami, Zakhia Saliba, Ghassan Chehab
OBJECTIVES: The main aim of this study is to evaluate the significance of several clinical and laboratory findings presented by a large number of pediatric patients who were suspected to have acute rheumatic fever (ARF) by physicians who ordered echocardiogram for confirmation and for avoiding overuse of unnecessary antibiotics. These suspecting reasons include elevated ASO titers and recurrent tonsillitis. Another aim is to stress the role of Doppler echocardiogram in confirming the diagnosis of ARF by detecting rheumatic heart disease (RHD) in suspected cases...
October 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
Bobby Yanagawa, Jagdish Butany, Subodh Verma
PURPOSE OF REVIEW: The purpose is to provide a broad overview of the current state of knowledge of pathogenesis, diagnosis, and management of rheumatic heart disease (RHD). RECENT FINDINGS: Studies on pathogenesis of RHD have focused on autoimmunity because of molecular mimicry between the streptococcal M antigen α-helical coiled-coil structure and sarcomeric proteins such as myosin and tropomyosin. More recently, nonsarcomeric autoantigens, endothelial injury and the innate immune system have been proposed to play key roles in the pathogenesis of RHD...
March 2016: Current Opinion in Cardiology
Rajeev Bhardwaj, Arvind Sood
INTRODUCTION: Rheumatic heart disease (RHD) is still a common cause of morbidity and mortality in India. Rheumatic fever commonly occurs between 5-15 yrs of age. Rheumatic activity is a common cause of deterioration of symptoms in a stable or undiagnosed case of RHD. MATERIAL AND METHODS: 41 consecutive patients of acute rheumatic activity were studied. Presenting symptoms were noted. Physical examination was done for major and minor Jone's criteria. Detailed cardiac examination was done...
April 2015: Journal of the Association of Physicians of India
Metin Cagdas, Yalcin Velibey, Tolga Sinan Guvenc, Baris Gungor, Ozge Guzelburc, Nazmi Calik, Murat Ugur, Ahmet Ilker Tekkesin, Kadir Gurkan, Mehmet Eren
BACKGROUND: Atrial electromechanical delay (AEMD) that reflects delayed conduction may show us the clinical reflection of pathological changes in the atria. The main objective of the present study is to investigate AEMD in patients who had previous rheumatic carditis but without hemodynamically significant valvular disease. METHODS: A total of 40 patients, previously diagnosed as rheumatic carditis but without significant valvular stenosis/regurgitation and atrial enlargement; and 39 age- and-sex matched controls were enrolled for the present study...
2015: Cardiology Journal
Antoinette Cilliers, Alma J Adler, Haroon Saloojee
BACKGROUND: Rheumatic heart disease remains an important cause of acquired heart disease in developing countries. Although prevention of rheumatic fever and management of recurrences have been well established, optimal management of active rheumatic carditis remains unclear. This is an update of a review published in 2003, and previously updated in 2009 and 2012. OBJECTIVES: To assess the effects, both harmful and beneficial, of anti-inflammatory agents such as aspirin, corticosteroids and other drugs in preventing or reducing further valvular damage in patients with acute rheumatic fever...
May 28, 2015: Cochrane Database of Systematic Reviews
Satoshi Sato, Masako Chiyotanda, Tae Hijikata, Yu Ishida, Shingo Oana, Gaku Yamanaka, Hisashi Kawashima, Kosuke Kubo
BACKGROUND: Acute rheumatic fever (ARF) is an illness caused by group A streptococcus (GAS) infection, and remains the leading cause of acquired heart disease in worldwide. Distinguishing between ARF and septic arthritis may be difficult. This report describes a case of suppurative arthritis overlapping with ARF. CASE PRESENTATION: A 4-year-old, previously healthy boy presented with fever and left leg pain. The level of anti-streptolysin O (ASO) was elevated. His throat swab cultures grew GAS, but none were detected in his synovial fluid...
August 2015: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Michael H Gewitz, Robert S Baltimore, Lloyd Y Tani, Craig A Sable, Stanford T Shulman, Jonathan Carapetis, Bo Remenyi, Kathryn A Taubert, Ann F Bolger, Lee Beerman, Bongani M Mayosi, Andrea Beaton, Natesa G Pandian, Edward L Kaplan
BACKGROUND: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever...
May 19, 2015: Circulation
Ramush A Bejiqi, Ragip Retkoceri, Naim Zeka, Hana Bejiqi, Arber Retkoceri
BACKGROUND: Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years...
February 2015: Medical Archives
Harsha K Chandnani, Renu Jain, Pisespong Patamasucon
BACKGROUND: Human infection with group C Streptococcus is extremely rare and a select number of cases have been reported to cause acute pharyngitis, acute glomerulonephritis, skin and soft tissue infections, septic arthritis, osteomyelitis, pneumonitis, and bacteremia. In pediatrics, this bacteria is known to cause epidemic food-borne pharyngitis, pneumonia, endocarditis, and meningitis, and has reportedly been isolated in the blood, meninges, sinuses, fingernail, peritonsillar abscess, and thyroglossal duct cyst, among others...
July 2015: Journal of Emergency Medicine
Chamarajnagar Mahadevappa Nagesh, Anita Saxena, Chetan Patel, Sellam Karunanithi, Murli Nadig, Arun Malhotra
BACKGROUND: We report the use of positron emission tomography (PET) using 18F-FDG for the diagnosis of carditis in children with rheumatic heart disease (RHD). MATERIAL AND METHODS: Thirty-six children aged 6-17 years (seventeen males and nineteen females) with isolated rheumatic significant mitral regurgitation (MR) underwent FDG-PET scanning of the heart after fasting for 6 h within a period of 2 years. They were divided into two groups based on Jones criteria - acute rheumatic carditis and chronic RHD...
2015: Nuclear Medicine Review. Central & Eastern Europe
Mike Sathekge, Anton Stoltz, Olivier Gheysens
We present a case of heterogeneous and strongly increased myocardial and valvular 18F-FDG uptake on 18F-FDG PET/CT in an HIV-positive patient with productive cough, fever, weight loss, and progressive dyspnea for 6 months. Contrast-enhanced CT did not reveal the cause of fever, but hyperechogenic valvular lesions on echocardiography in combination with PET/CT findings are suggestive of endocarditis/myocarditis. Postmortem histology 3 weeks after PET/CT showed Aschoff bodies with Anitschkow cells, pathognomonic for rheumatic carditis...
March 2015: Clinical Nuclear Medicine
Guilherme S Spina, Roney O Sampaio, Carlos E Branco, George B Miranda, Vitor E E Rosa, Flávio Tarasoutchi
Rheumatic fever (RF) remains endemic in many countries and frequently causes heart failure due to severe chronic rheumatic valvular heart disease, which requires surgical treatment. Here, we report on a patient who underwent an elective surgical correction for mitral and aortic valvular heart disease and had a post-operative diagnosis of acute rheumatic carditis. The incidental finding of Aschoff bodies in myocardial biopsies is frequently reported in the nineteenth-century literature, with prevalences as high as 35%, but no clinical or prognostic data on the patients is included...
2014: Frontiers in Pediatrics
Elise R Breed, Bryce A Binstadt
Autoimmune carditis is associated with many human rheumatic conditions, including rheumatic fever, systemic lupus erythematosus, and rheumatoid arthritis. The immune mechanisms that mediate the cardiovascular pathology connected to these diseases are poorly defined. Several animal models are used to recapitulate human pathophysiology in order to better characterize the immunopathogenic mechanisms driving autoimmune endocardial inflammation. These animal models point toward common mechanisms mediating autoimmune endocarditis; in particular, CD4+ T cells and pro-inflammatory macrophages play critical roles in directing the disease process...
January 2015: Current Allergy and Asthma Reports
Mustafa Argun, Ali Baykan, Figen Narin, Abdullah Özyurt, Özge Pamukçu, Ferhan Elmalı, Kazım Üzüm, Nazmi Narin
BACKGROUND: Acute rheumatic fever is an autoimmune, inflammatory, and multi-systemic disease secondary to pharyngitis and is caused by group A streptococcus. In developing countries, acute rheumatic fever is the most common cause of acquired heart disease. Gelsolin is a calcium-dependent, multi-functional actin-regulatory protein circulating in the plasma of healthy human beings. The correlation between blood gelsolin levels and inflammatory conditions suggests the potential benefit of gelsolin as a prognostic marker...
October 2015: Cardiology in the Young
Amanda Chikly, Ronen Durst, Chaim Lotan, Shmuel Chen
Myocarditis consists of an inflammation of the cardiac muscle, definitively diagnosed by endomyocardial biopsy. The causal agents are primarily infectious: in developed countries, viruses appear to be the main cause, whereas in developing countries rheumatic carditis, Chagas disease, and HIV are frequent causes. Furthermore, myocarditis can be indirectly induced by an infectious agent and occurs following a latency period during which antibodies are created. Typically, myocarditis observed in rheumatic fever related to group A streptococcal (GAS) infection occurs after 2- to 3-week period of latency...
2014: Case Reports in Cardiology
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