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Results for “Rheumatic Fever”

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PubMed1993

[Incidence of rheumatic fever in Slovakia during the last 20 years].

The incidence of rheumatic fever has a declining trend in Slovakia. In 1972 there were 26.7 primary attacks and 8.7 relapses per 100,000 children aged 0-14 years, in 1990 there are 0.5 primary attacks and 0.4 relapses and in 1991 0.4 primary attacks and no relapses. The interregional (former regions) distribution was to the disadvantage of eastern parts but gradually this was evened out. Rheumatic fever occurs in girls and boys, in the majority mild arthritis forms are involved with unequivocal regression of carditic-arthritic forms. The decline can be ascribed to the rising socio-economic standard and health care.

Adolescent↗
PubMed1990

An outbreak of acute rheumatic fever in Tennessee.

From January, 1987, until July, 1988, a significant increase in newly diagnosed cases of acute rheumatic fever was noted at our hospital. In sharp contrast to the 3 cases seen in 1986, 14 cases were diagnosed in 1987 (a significant increase from 1985 to 1986, P = 0.001). In the first 6 months of 1988 an additional 12 new cases were diagnosed (a further significant increase from 1987, P = 0.02). No further cases were diagnosed between July, 1988, and September, 1989. The major clinical manifestations were carditis in 73%, polyarthritis in 58% and chorea in 31%. In 15 of 26 patients an antecedent illness which included pharyngitis was noted; the remainder of patients were asymptomatic. Group A beta-hemolytic streptococci were isolated from 13 of 19 children cultured. Isolates from two patients with acute rheumatic fever were submitted for M typing: one isolate was mucoid M18/T18; the other isolate was a mucoid nontypable strain. The demographic characteristics of the 26 patients agree with classic descriptions in that patients were more likely to be urban, to come from large families and to have low incomes; racial breakdown of the group mirrored the Tennessee pediatric population. These characteristics stand in contrast to reports of recent outbreaks which describe suburban high income patients. These data suggest that practitioners should be again aware of acute rheumatic fever and that aggressive identification and treatment of streptococcal pharyngitis should continue to be a relevant public health concern.

Acute Disease↗
PubMed1980

The value of an indirect hemagglutination test for streptococcal antibodies in children with acute rheumatic fever.

This study was made to evaluate the value of the IHA test for streptococcal antibodies in children with acute rheumatic fever in comparison with the conventional ASO titer. The upper limit titers of ASO and IHA in control group were 170 and 640 respectively. All sera from 37 patients with rheumatic fever had IHA titers over 640. In contrast, the level of ASO titer above upper normal limits was found in only 62% of these cases. This report present data which favours the use of IHA test. Its sensitivity is very similar to that of the commercial Anti Streptozyme test. In addition, the test is simple and could be performed economically. More studies are needed to evaluate the test further. If the results proved as favourable as this report a negative test would be of a considerable value in excluding the diagnosis of acute, rheumatic fever especially in questionable cases.

Acute Disease↗
PubMed2005

[Activity of lipid peroxidation processes and the condition of antioxidative defense system in children with rheumatic fever].

Aim of study consists of establishing of some clinical-biological correlates for rheumatic fever (RF) in children, namely correlations between clinical status and lipoperoxidation products -- malonidialdehide (MDA) and antioxidative enzymes in the blood. In the neutralization process of superoxside anions ceruloplazmin (CP), catalase (CAT) and transferin (TF) are key antioxidant enzymes (AOE) of antioxidative defense system (AOD). We studied 38 patients 3-15 years of age with different variants of RF. We measured the levels of MDA, CAT, CP, TF in the plasma in patients with acute rheumatic fever (ARF) and chronic rheumatic heart disease (CRHD). In all of our cases AOE (CAT, CP, TF) were high at time of diagnosis, concomitant with increased MDA and inflammatory tests. Our study revealed intensified activity of AOD enzymes in children with RF.

Adolescent↗
PubMed2006

Evolution of valve damage in Sydenham's chorea during recurrence of rheumatic fever.

BACKGROUND: The evolution of valve damage during a recurrence, in a patient who did not have apparent carditis in the initial attack of Sydenham's chorea, has been a subject of debate. METHODS: Thirty-six patients with an initial episode of acute rheumatic fever and Sydenham's chorea (3 patients with subclinical mitral regurgitation) were followed up prospectively for 5 years. Clinical examinations and transthoracic color Doppler echocardiography were done for each patient at initial attacks of Sydenham's chorea and at recurrences of rheumatic fever. RESULTS: Six recurrences of rheumatic fever occurred in 6 of the 36 patients. One recurrence developed in the regular secondary prophylaxis group (27 patients) with a recurrence rate of 0.007 per patient-year. Three of the 18 patients who initially had no heart murmur and no echocardiographic finding of valvular regurgitation had three recurrences of pure chorea with no echocardiographic evidence of significant valvular regurgitation. Interestingly, one of the 3 patients with previous pure chorea and echocardiographic finding of significant mitral regurgitation had a recurrence of pure chorea and new echocardiographic evidence of mitral, aortic and tricuspid regurgitations. Furthermore, two recurrences occurring in 2 of the 15 patients with previous carditis developed echocardiographic evidence of new carditis. CONCLUSIONS: Rheumatic recurrence can develop new valve damage evident by echocardiography for the patient with pure Sydenham's chorea who had previous subclinical valvulitis. Longer duration of secondary prophylaxis is recommended to prevent a recurrence of rheumatic fever in the patient with pure Sydenham's chorea who initially had subclinical valvulitis.

Acute Disease↗
PubMed1994

Seven-year national survey of Kawasaki disease and acute rheumatic fever.

To assess the frequency of hospital encoded diagnoses of acute rheumatic fever (ARF) and Kawasaki disease (KD), the two leading causes of acquired heart disease in children in the United States, we performed a survey of the medical record departments of United States children's hospitals and of general hospitals that have at least 400 beds and a pediatric ward. With a simple questionnaire, data were gathered for the years 1984 through 1990 by ICD.9CM codes, with a 58% response rate. About 8000 diagnoses of KD and 6000 diagnoses of ARF were encoded during the study period. Encoded diagnoses of both KD and ARF showed yearly fluctuations in the earlier years (1984 through 1987). For KD there was a general trend toward increasing numbers after 1986. These data are consistent with increased physician awareness and diagnosis of KD. For ARF a gradual decline was observed between 1986 and 1990. About 80% of ARF diagnoses were reported from general hospitals. The much smaller pool of encoded diagnoses of ARF at the children's hospitals showed a 56% increase from 1985 to 1986. These data suggest that the highly publicized increase in cases of acute rheumatic fever in the United States during the mid-1980s may reflect focal rather than nationwide increased activity and that nationally the number of diagnoses of ARF actually may have continued to decline gradually from 1984 through 1990.

Analysis of Variance↗
PubMed1989

Acute rheumatic fever with advanced degree AV block.

Five cases are described of acute rheumatic fever meeting the modified Jones criteria with evidence of second or third degree atrioventricular block (AVB). One patient required a temporary transvenous pacemaker and two patients were treated with corticosteroids. One patient had an associated valvulitis. There was no long-term sequelae due to the AVB in any of the patients. The duration of the advanced degree AVB had a range of about 2 to 12 days. The cause of this advanced degree AVB is uncertain. Advanced degree AVB with acute rheumatic fever appears to be self-limited in most instances. Unlike rheumatic valvulitis, it is not associated with significant permanent morbidity.

Acute Disease↗
PubMed1990

Acute rheumatic fever in adults.

Thirty-one adults with acute rheumatic fever were identified at Groote Schuur Hospital over a 10-year period. In keeping with other series, arthritis was the most common major criterion. However, unlike other series, cardiac involvement was a prominent feature. Two patients died and a further 4 required valve replacements as a result of the disease. This suggests that local factors are of importance in determining the morbidity of the disease and that physicians should consider acute rheumatic disease in adults who present with unexplained valvular disease or carditis.

Acute Disease↗
PubMed2000

Diagnosis of rheumatic fever: current status of Jones Criteria and role of echocardiography.

The original Jones Criteria as proposed by Dr. T. Duckett Jones have been modified four times and the updated revised criteria were published in 1992. According to this latest publication major manifestations are carditis, polyarthritis, chorea, erythema marginatum and subcutaneous nodules. Minor manifestations include fever, arthralgia and laboratory findings of elevated erythrocyte sedimentation rate, C-reactive protein and prolonged PR interval on ECG. For making a diagnosis of acute rheumatic fever, two major, or one major and two minor manifestations must be accompanied by supporting evidence of antecedent group A streptococcal infection in the form of positive throat culture or elevated or rising anti-streptolysin titre. The updated guidelines also highlighted a subgroup of "exceptions to Jones Criteria" for patients with chorea, indolent carditis and previous history of rheumatic fever or "rheumatic heart disease". Role of echocardiography has not been defined in these modifications but may be important, as clinical detection of soft murmurs may be difficult due to tachycardia. Doppler and color flow mapping is more sensitive in picking up minor digress of valvular regurgitation. Several studies have confirmed that the yield of carditis with valvular regurgitation increased with use of echocardiography in patients with acute rheumatic fever. Also echocardiography is of great help in mixed valve lesions to determine the severity of each lesion. Other abnormalities detected on echocardiography in acute carditis include prolapse of the valve, focal nodular thickening of leaflets and pericardial effusion. Jones Criteria are guidelines to assist the physician and should not be substituted for clinical judgement as strictly following them may result in underdiagnosis of this disease in our country.

Biopsy↗
PubMed1988

Acute rheumatic fever in the young: changing prevalence and pattern.

Acute rheumatic fever (ARF) is rare in young people. A group of 28 patients is described who were hospitalized during the years 1960-1984. Patients were divided into two groups: children who were admitted between 1960 and 1966 and those admitted between 1966 and 1984. The annual incidence of ARF declined from 1.17 to 0.44 cases per 10,000 population at risk. The incidence of arthritis declined in parallel to the decrease in number of children presenting with ARF, whereas the incidence of carditis remained the same.

Acute Disease↗