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Anticardiolipin antibodies in acute rheumatic fever and chronic rheumatic heart disease: is there a significant association?

OBJECTIVE: The incidence and significance of IgG and IgM anticardiolipin antibodies (aCLa) in patients with acute rheumatic fever (ARF), chronic rheumatic heart disease (CRHD) and streptococcal pharyngitis have been investigated in order to determine whether these antibodies play an important role in the pathogenesis and if they are markers that can be used to confirm disease activity. METHODS: An enzyme-linked immunosorbent assay was used to measure the IgG and IgM aCLa levels. aCLa levels of patients were considered positive if they were greater than 3.0 standard deviations above the mean for healthy children. RESULTS: No significant difference in aCLa levels was found between patients with rheumatic fever or streptococcal pharyngitis and healthy controls, and aCLa concentrations did not correlate with the acute phase reactant levels. CONCLUSIONS: aCLa in patients with ARF and CRHD do not appear to be markers of disease activity, and our data suggest that aCLa do not play an important role in the pathogenesis of rheumatic fever.

Adolescent↗

Rheumatic fever and rheumatic heart disease among 56,8000 inhabitants in southeast Teheran from 1972-1974.

A study of the incidence of R. fever in an area in southeast Teheran during the period 1972-1974 revealed 92 cases. The crude annual incidence of R. fever ranged from a high of 58 cases to a low of 51 cases per 100,000 population. The age and sex specific rates revealed the incidence to be strikingly higher in the 5-19 year age group, reaching roughly 80/100,000. There was an approximately similar number of males and females with R. fever. Among the R. fever patients, there were 6 cases of chorea, 5 girls and 1 boy. From 92 R. fever cases, 49 (53%) developed carditis. Among these patients, 35 (71%) were female in contrast to 14 (29%) male cases. Overall there were 59 cases (62%) which were initial attacks and 33 cases (38%) which were recurrences. During the trial there were also 7 recurrences of R fever and 4 deaths. The seasonal pattern showed that the majority of cases occurred during the winter and spring months. From the R. fever/R.H.D. patients, 63 (70%) and from cases with carditis alone, 24 (40%) were hospitalized.

Adolescent↗

Ethnic differences in mortality from acute rheumatic fever and chronic rheumatic heart disease in New Mexico, 1958-1982.

To examine time trends and differences in mortality rates from acute rheumatic fever and chronic rheumatic heart disease in New Mexico's Hispanic, American Indian, and non-Hispanic white populations, we analyzed vital records data for 1958 through 1982. Age-adjusted mortality rates for acute rheumatic fever were low and showed no consistent temporal trends among the three ethnic groups over the study period. Age-adjusted and age-specific mortality rates for chronic rheumatic heart disease in Hispanic and non-Hispanic whites decreased over the 25-year period, although rates were higher among Hispanics than among non-Hispanics during most of the time period. In American Indians, age-adjusted mortality rates for chronic rheumatic heart disease increased between 1968 and 1977 to twice the non-Indian mortality rates during the same period. Despite this increase in mortality from chronic rheumatic heart disease among New Mexico's American Indians from 1968 to 1977, the New Mexico data generally reflect national trends of decreasing mortality from chronic rheumatic heart disease.

Acute Disease↗

Plasma interleukin-7 (IL-7) and IL-8 concentrations in acute rheumatic fever and chronic rheumatic heart disease.

Interleukin-7 (IL-7) and IL-8 productions in 25 children with acute rheumatic fever (ARF) and in 15 children with chronic rheumatic heart disease (CRHD) and in 15 children with streptococcal pharyngitis (SP), were investigated in order to determine whether they have a role in the pathogenesis of rheumatic fever. Significantly higher IL-8 levels were found in ARF patients in the clinically active period. IL-7 concentrations remained unchanged during different stages of rheumatic fever. The decrease of elevated IL-8 concentrations within 3 months and normal IL-8 concentrations in patients with CRHD and SP indicate an excessive production of IL-8, probably by cellular infiltrates in the joint throughout the active period of rheumatic disease.

Adolescent↗