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Rheumatic Fever

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https://www.readbyqxmd.com/read/29780139/methotrexate-associated-intravascular-large-b-cell-lymphoma-in-a-patient-with-rheumatoid-arthritis-a-very-rare-case
#1
Masao Hagihara, Toru Mese, Shin Ohara, Jian Hua, Shiro Ide, Morihiro Inoue
we herein report a rare case of methotrexate (MTX)-associated intravascular large B-cell lymphoma (IVLBCL) in a man with rheumatoid arthritis. Two episodes of a fever of unknown origin accompanied by elevated levels of serum lactate dehydrogenase and the soluble interleukin-2 receptor occurred within a year, so the patient was suspected of having an MTX-associated lymphoproliferative disorder. His clinical symptoms resolved after the cessation of MTX. However, after treatment with iguratimod, another disease-modified anti-rheumatic drug, markedly similar symptoms recurred, and random skin biopsies resulted in a diagnosis of IVLBCL...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29771193/early-symptoms-of-systemic-lupus-erythematosus-sle-recalled-by-339-sle-patients
#2
N Leuchten, B Milke, B Winkler-Rohlfing, D Daikh, T Dörner, S R Johnson, M Aringer
Objective The European League Against Rheumatism and the American College of Rheumatology jointly embarked on a new classification criteria for systemic lupus erythematosus (SLE) project. Its first phase involved generation of a broad set of items potentially useful for classification of SLE. This study was undertaken to add the patient perspective to an expert Delphi approach and an early patient cohort study. Methods A national cross-sectional study was conducted. A self-report questionnaire was published in the "Schmetterling" (Butterfly), the quarterly journal of the German SLE patient association...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29759083/hypertrophic-osteoarthropathy-mimicking-a-reactive-arthritis-a-case-report-and-review-of-the-literature
#3
Francesco Bozzao, Stella Bernardi, Franca Dore, Lorenzo Zandonà, Fabio Fischetti
BACKGROUND: Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of skin and periosteal tissues of the extremities. It can be a rare hereditary disease (pachydermoperiostosis) or can be secondary to various diseases, though mostly lung malignancies. Here, we report an unusual clinical presentation of HOA. CASE PRESENTATION: A 77-year-old man presented with fever, diarrhea, and an oligoarthritis involving the left knee and the ankles...
May 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29737105/-analysis-of-pathogens-and-clinical-characteristics-in-157-cases-with-infective-endocarditis
#4
Fei-Fei Zhao, Yang Lu, Hui Ye, Ce-Jun Zhong, Liang Huang, Xiao-Ju Lü
OBJECTIVE: To analyze the clinical characteristics of infective endocarditis (IE) in culture-positive patients,so as to provide the evidences for reasonable diagnosis and treatment of IE. METHODS: We performed a retrospective study of 157 culture-positive IE cases,which were diagnosed according to modified Duke criteria for IE from Jan. 2008 to Aug. 2015. RESULTS: The average age of 157 cases of IE was 40.85 years. One hundred and one patients (64...
January 2018: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29716706/systolic-aortic-regurgitation-in-rheumatic-carditis-mechanistic-insight-by-doppler-echocardiography
#5
Jagdish C Mohan, Vishwas Mohan, Madhu Shukla, Arvind Sethi
BACKGROUND: Aortic regurgitation (AR) usually occurs in diastole in presence of an incompetent aortic valve. Systolic AR is a rare phenomenon occurring in patients with reduced left ventricular systolic pressure and atrial fibrillation or premature ventricular contractions. Its occurrence is a Doppler peculiarity and adds to the hemodynamic burden. AIM: Rheumatic carditis is often characterised by acute or subacute severe mitral regurgitation (MR) due to flail anterior mitral leaflet and elongated chords...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29709345/the-jones-criteria-for-the-diagnosis-of-acute-rheumatic-fever-updated-but-not-abandoned
#6
EDITORIAL
Michael Gewitz
No abstract text is available yet for this article.
April 27, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29709007/chikungunya-virus-infection-in-aruba-diagnosis-clinical-features-and-predictors-of-post-chikungunya-chronic-polyarthralgia
#7
Ralph Huits, Jaclyn De Kort, Riemsdijk Van Den Berg, Luis Chong, Achilleas Tsoumanis, Kaat Eggermont, Koen Bartholomeeusen, Kevin K Ariën, Jan Jacobs, Marjan Van Esbroeck, Emmanuel Bottieau, Lieselotte Cnops
BACKGROUND: Chikungunya virus (CHIKV) emerged in Aruba for the first time in 2014. We studied the clinical presentation of acute CHIKV infection and the contribution of serologic and molecular assays to its diagnosis. In a cohort of confirmed CHIKV cases, we analysed the frequency, duration and predictors of post-chikungunya chronic polyarthralgia (pCHIK-CPA), defined as joint pains lasting longer than 6 weeks or longer than 1 year. METHODOLOGY: Patient sera obtained within 10 days of symptom onset were tested for CHIKV, using an indirect immunofluorescence test for the detection of CHIKV-specific Immunoglobulin M (IgM) and post-hoc, by reverse-transcription polymerase chain reaction (RT-PCR)...
2018: PloS One
https://www.readbyqxmd.com/read/29706647/the-microbiome-and-autoimmunity-a-paradigm-from-the-gut-liver-axis
#8
REVIEW
Bo Li, Carlo Selmi, Ruqi Tang, M E Gershwin, Xiong Ma
Microbial cells significantly outnumber human cells in the body, and the microbial flora at mucosal sites are shaped by environmental factors and, less intuitively, act on host immune responses, as demonstrated by experimental data in germ-free and gnotobiotic studies. Our understanding of this link stems from the established connection between infectious bacteria and immune tolerance breakdown, as observed in rheumatic fever triggered by Streptococci via molecular mimicry, epitope spread and bystander effects...
April 30, 2018: Cellular & Molecular Immunology
https://www.readbyqxmd.com/read/29694606/cardiovascular-abnormalities-in-patients-with-oral-cleft-a-clinical-electrocardiographic-echocardiographic-study
#9
Gisele C P Leite, Marcela A G Ururahy, João F Bezerra, Valéria M G D M Lima, Maria I F Costa, Sandra S C Freire, André D Luchessi, Jussara M C Maia, Maria E F Brito, Vera L Gil-da-Silva-Lopes, Adriana A Rezende
OBJECTIVES: The present study aims to describe the clinical, electrocardiographic, and echocardiographic cardiological findings in a group of patients with oral clefts. METHODS: This is a prospective cross-sectional study on 70 children (age range from 13 days to 19 years) with oral clefts who attended the multidisciplinary program of a university hospital from March 2013 to September 2014. The patients were evaluated by a pediatric cardiologist and underwent detailed anamnesis, physical examination, electrocardiogram, and echocardiogram...
2018: Clinics
https://www.readbyqxmd.com/read/29687155/takayasu-arteritis-in-childhood-misdiagnoses-at-disease-onset-and-associated-diseases
#10
Gleice Clemente, Clovis A Silva, Silvana B Sacchetti, Virginia P L Ferriani, Sheila K Oliveira, Flavio Sztajnbok, Blanca E R G Bica, André Cavalcanti, Teresa Robazzi, Marcia Bandeira, Maria Teresa Terreri
Juvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses...
April 23, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29686441/rheumatic-fever-new-diagnostic-criteria
#11
REVIEW
Izabela Szczygielska, Elżbieta Hernik, Beata Kołodziejczyk, Agnieszka Gazda, Maria Maślińska, Piotr Gietka
Rheumatic fever (RF) is an autoimmune disease associated with group A β-hemolytic streptococcal infection, in the course of which the patient develops carditis, arthritis, chorea, subcutaneous nodules and erythema marginatum. Rheumatic fever diagnosis is based on the Jones criteria, developed in 1944, then revised twice by the American Heart Association (AHA), in 1992 and recently in 2015. The last revision of the Jones criteria consists mainly in the supplementation of the major criteria with echocardiographic examination, the introduction of a concept of subclinical carditis and the isolation of low, medium and high risk populations among the patients...
2018: Reumatologia
https://www.readbyqxmd.com/read/29679253/fever-of-unknown-origin-fuo-cmv-infectious-mononucleosis-or-lymphoma
#12
Burke A Cunha, Karishma Chawla
Fever of unknown origin (FUO) refers to fevers of > 101 °F that persist for > 3 weeks and remain undiagnosed after a focused inpatient or outpatient workup. FUO may be due to infectious, malignant/neoplastic, rheumatic/inflammatory, or miscellaneous disorders. The FUO category determines the focus of the diagnostic workup. In the case presented of an FUO in a young woman, there were clinical findings of both CMV infectious mononucleosis or a lymphoma, e.g., highly elevated ESR, elevated ferritin levels, and elevated ACE level, β-2 microglobulins...
April 20, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29671499/poststreptococcal-illness-recognition-and-management
#13
David L Maness, Michael Martin, Gregg Mitchell
Group A beta-hemolytic streptococcus can cause several postinfectious, nonsuppurative immune- mediated diseases including acute rheumatic fever, poststreptococcal reactive arthritis, pediatric autoimmune neuropsychiatric disorders, and poststreptococcal glomerulonephritis. Except for sporadic outbreaks, poststreptococcal autoimmune syndromes occur most commonly in sub-Saharan Africa, India, Australia, and New Zealand. Children younger than three years are rarely affected by group A streptococcus pharyngitis or rheumatic fever, and usually do not require testing...
April 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29617499/mortality-predictors-in-the-surgical-treatment-of-active-infective-endocarditis
#14
Jenny Lourdes Rivas de Oliveira, Magaly Arrais Dos Santos, Renato Tambellini Arnoni, Auristela Ramos, Dorival Della Togna, Samira Kaissar Ghorayeb, Roberto Tadeu Magro Kroll, Luiz Carlos Bento de Souza
INTRODUCTION: Active infective endocarditis is associated with high morbidity and mortality. Surgery is indicated in high-risk conditions, and the main determinants of mortality in surgical treatment should be evaluated. OBJECTIVE: To identify mortality predictors in the surgical treatment of active infective endocarditis in a long-term follow-up. METHODS: This prospective observational study involved 88 consecutive patients diagnosed with active infective endocarditis, who underwent surgery between January 2005 and December 2015...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29606414/poststreptococcal-reactive-arthritis-in-japan
#15
Maria Nishibukuro, Norito Tsutsumi, Masako Chiyotanda, Tae Hijikata, Shinichiro Morichi, Soupei Go, Gaku Yamanaka, Yasuyo Kashiwagi, Hisashi Kawashima
Reactive arthritis after Group A streptococcal infection (poststreptococcal reactive arthritis: PSRA) that does not meet the Jones criteria for acute rheumatic fever (ARF) has been reported as a new entity for over a decade. In Japan there are few reports of PSRA. We encountered four children with arthritis accompanied with Group A streptococcal infection in our department. We investigated our cases and the recent Japanese literature. Japanese cases of PSRA are frequently accompanied with uveitis and erythema nodosum, and tonsillectomy resolved their symptoms in some cases...
March 29, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29605389/epidemiologic-impact-of-the-new-guidelines-for-the-diagnosis-of-acute-rheumatic-fever
#16
Francesco Licciardi, Giacomo Scaioli, Roberta Mulatero, Agostina Marolda, Marta Delle Piane, Silvana Martino, Davide Montin, Pier Angelo Tovo
OBJECTIVES: To estimate the incidence of acute rheumatic fever (ARF) in a metropolitan area of Northern Italy and study how the introduction of the 2015 revised Jones criteria affects the epidemiology in a region with moderate to high incidence of ARF. STUDY DESIGN: The incidence of ARF in children 5-14 years old living in the Province of Turin was estimated using low-risk criteria in a 10-year period (group A patients). The proportion of patients fulfilling only high-risk (HR) criteria (group B patients) was also calculated both prospectively (from July 2015 through December 2016) and retrospectively (from January 2007 through June 2015)...
March 28, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29562920/the-safety-of-live-attenuated-vaccines-in-patients-using-il-1-or-il-6-blockade-an-international-survey
#17
Jerold Jeyaratnam, Nienke M Ter Haar, Helen J Lachmann, Ozgur Kasapcopur, Amanda K Ombrello, Donato Rigante, Fatma Dedeoglu, Ezgi H Baris, Sebastiaan J Vastert, Nico M Wulffraat, Joost Frenkel
BACKGROUND: Withholding live-attenuated vaccines in patients using interleukin (IL)-1 or IL-6 blocking agents is recommended by guidelines for both pediatric and adult rheumatic diseases, since there is a risk of infection in an immune suppressed host. However, this has never been studied. This retrospective, multicenter survey aimed to evaluate the safety of live-attenuated vaccines in patients using IL-1 or IL-6 blockade. METHODS: We contacted physicians involved in the treatment of autoinflammatory diseases to investigate potential cases...
March 21, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29554121/group-a-streptococcus-pharyngitis-and-pharyngeal-carriage-a-meta-analysis
#18
Jane Oliver, Erandi Malliya Wadu, Nevil Pierse, Nicole J Moreland, Deborah A Williamson, Michael G Baker
OBJECTIVE: Antibiotic treatment of Group A Streptococcus (GAS) pharyngitis is important in acute rheumatic fever (ARF) prevention, however clinical guidelines for prescription vary. GAS carriers with acute viral infections may receive antibiotics unnecessarily. This review assessed the prevalence of GAS pharyngitis and carriage in different settings. METHODS: A random-effects meta-analysis was performed. Prevalence estimates for GAS+ve pharyngitis, serologically-confirmed GAS pharyngitis and asymptomatic pharyngeal carriage were generated...
March 19, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29552369/efficacy-of-cyclosporine-in-the-induction-and-maintenance-of-remission-in-a-systemic-lupus-erythematosus-patient-presenting-with-macrophage-activating-syndrome
#19
Franchesca Cruz-Pérez, Salvador Vilá, Grissel Ríos, Luis M Vilá
Macrophage-activating syndrome (MAS) is a rare condition characterized by dysfunctional macrophage activation leading to overproduction of cytokines and phagocytosis of erythrocytes, leukocytes, and platelets. MAS is associated with infectious diseases, malignancies, and autoimmune rheumatic disorders. Herein, we present a 22-year-old Hispanic woman with SLE who was hospitalized because of a three-week history of fever, fatigue, polyarthralgia, nausea, and abdominal pain. Initial laboratories showed severe pancytopenia with marked elevation of liver enzymes and ferritin levels...
2018: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29548280/comprehensive-microrna-profiling-reveals-potential-augmentation-of-the-il1-pathway-in-rheumatic-heart-valve-disease
#20
Qiyu Lu, Yi Sun, Yuyin Duan, Bin Li, Jianming Xia, Songhua Yu, Guimin Zhang
BACKGROUND: Valvular heart disease is a leading cause of cardiovascular mortality, especially in China. More than a half of valvular heart diseases are caused by acute rheumatic fever. microRNA is involved in many physiological and pathological processes. However, the miRNA profile of the rheumatic valvular heart disease is unknown. This research is to discuss microRNAs and their target gene pathways involved in rheumatic heart valve disease. METHODS: Serum miRNA from one healthy individual and four rheumatic heart disease patients were sequenced...
March 16, 2018: BMC Cardiovascular Disorders
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