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Results for “Rheumatic Fever”

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PubMed2003

Naproxen as an alternative to aspirin for the treatment of arthritis of rheumatic fever: a randomized trial.

We performed a prospective, randomized, open-label equivalence study comparing the use of naproxen to aspirin in 33 patients with rheumatic fever. The mean time until resolution of arthritis was 2.9+/-2.9 days in both groups. Liver enzyme elevations were more frequent in the aspirin group (P=.002). We conclude that naproxen is as effective, is easier to use, and is safer than aspirin in the treatment of the arthritis of rheumatic fever.

Adolescent↗
PubMed2006

[Acute rheumatic fever in children, a diagnostic problem].

Three girls of Moroccan descent, aged 9, 10 and 7 years, presented with fever, joint pain and other symptoms. After Streptococcus infection and carditis were confirmed and the Jones criteria for acute rheumatic fever were met, the patients were treated with penicillin and acetylsalicylic acid. All 3 patients recovered. However, the second girl presented 2 months later with cardiac decompensation caused by valve disorders, after which aortic and mitral valvuloplasty was performed. The third girl developed joint pain again after 3 weeks and was diagnosed with juvenile idiopathic arthritis; treatment was adjusted accordingly. The prevalence of rheumatic heart diseases is 10-20 times higher in developing countries than in industrialised nations. The diagnosis 'acute rheumatic fever' should be considered in children of school age with unexplained fever, also when the Jones criteria have not yet been met. This may apply to migrant children in particular.

Acute Disease↗
PubMedDate not supplied

Acute rheumatic fever with three major criteria: polyarthritis, carditis and chorea. A case report.

An eight-year-old girl is presented with three major criteria of acute rheumatic fever: polyarthritis, carditis and chorea. The diagnosis was confirmed with a history of pharyngitis 15 days prior to admission and with the findings of positive acute phase reactants such as elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), elevated anti-streptolysin-O (ASO) titration, and clinical findings of polyarthritis, carditis and chorea. Patient responded well to salicylate and phenobarbital treatment. The rare association of these three major criteria in acute rheumatic fever is emphasized.

Acute Disease↗
PubMed1987

Rheumatic fever as a cause of myocardial infarction with coronary narrowing.

A 12-year-old boy with rheumatic fever associated with myocardial infarction is presented. As sequelae, left ventricular aneurysm and diffuse narrowing of the anterior descending branch of the left coronary artery were demonstrated by angiography. Given the high incidence of coronary arteritis in rheumatic fever, it is likely that arteritis contributed to the infarction.

Child↗
PubMed2000

Communicating information about sore throats and rheumatic fever to South Auckland high-school students.

AIMS: The present study examined the effectiveness of three modes of communication designed to increase high school students' knowledge about throat infections and rheumatic fever in a high risk area. METHODS: The study was part of an evaluation of a rheumatic fever prevention programme that has established 27 school-based 'sore throat' clinics in South Auckland. The rationale for the clinics was explained to students through: assemblies conducted by public health nurses, written information sheets and classroom lessons. The effectiveness of each communication mode was assessed by comparing the knowledge of students from eight classes at an intervention school with eight classes at a control school before and after the intervention school students received the teaching. RESULTS: Students at the intervention school showed a significant improvement in knowledge compared to students at the control school. The assembly presentations by health professionals were more effective in informing students than information sheets or classroom lessons. CONCLUSIONS: This study suggests that presentations by health professionals are an effective method of teaching basic health information to students in these South Auckand secondary schools. Classroom teachers need to be provided with appropriate resources, if they are to provide effective instruction. Written information sheets should not be relied on.

Adolescent↗
PubMed2002

[Acute rheumatic fever, Sydenham's chorea and psychopathology].

Acute rheumatic fever (ARF) is an autoimmune disorder that is triggered by group A beta-hemolytic streptococcal infections. ARF consists of several combinations of carditis, polyarthritis and Sydenham's chorea, and rarely seen erythema marginatum and subcutaneous nodules. Sydenham's chorea is seen in about 20% of patients with ARF. As a late symptom of ARF, Sydenham's chorea usually occurs 3 months or longer after the streptococcal infection. Sydenham's chorea is a neuropsychiatric disorder that may present with emotional lability, anxiety, obsessive compulsive symptoms, attention deficit and hyperactivity symptoms or tics. Obsessive-compulsive symptoms occur in 70% of patients with Sydenham's chorea. The role of the autoimmune mechanisms and the dysfunction of the basal ganglia have been demonstrated in Sydenham's chorea. Antibodies against group A beta-hemolytic streptococcus cross-react with basal ganglia. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) shares the same mechanism with Sydenham's chorea, but PANDAS has not been shown to require penicillin prophylaxis. Thus it is important to distinguish between them. Sydenham's chorea is associated with adulthood OCD, Tourette syndrome and schizophrenia. These features make Sydenham's chorea an explanatory model for obsessive-compulsive disorder (OCD) and related disorders. This poststreptococcal disorder provides a treatment opportunity with new therapies like antibiotic therapy, plasma exchange and intravenous immunoglobulin therapy for psychiatric disorders. In this paper we summarize the phenomenological and treatment studies of OCD, attention deficit and hyperactivity disorder (ADHD), and tic disorders in subjects with ARF, with or without Sydenham's chorea.

English Abstract↗
PubMed1999

Humoral immune response in a sample of Bangladeshi children with rheumatic fever.

Several researchers have investigated cellular response, and antibody response to different antigens of group A beta-haemolytic streptococci, cardiac tissues and B cell alloantigen in rheumatic fever (RF). However, immunoglobulins (Ig) which may indicate general immune status did not receive attention. This study was done in the outpatient clinic of the National Center for Control of Rheumatic Fever and Heart Diseases, Dhaka, to compare Ig levels in subjects with and without RF who have had recent group A beta-haemolytic streptococcal infections. We have recruited 44 RF cases aged 5 to 20 years, and 44 subjects without RF were randomly matched for age and sex as controls. Convalescent blood samples were used to measure antistreptolysin O and IgG, IgM, and IgA levels. The cases, as compared with the controls, had significantly higher levels of antistreptolysin O (mean 399 versus 321 IU/ml), IgG (mean 2386 versus 1885 mg/dl), IgM (mean 286 versus 222 mg/dl) and IgA (mean 258 versus 184 mg/dl). It is not clearly known why the immune response is higher in the RF cases. We have to elucidate factors responsible for higher immune response in children with RF.

Adolescent↗
PubMed1979

[A comparative study of two similar groups of 364 children treated for rheumatic fever according to identical protocols (1955--1961, 1965--1972) (author's transl)].

From 1955 through 1972, all children admitted to two after-care centers for rheumatic fever were examined by the same physicians with the same diagnostic criteria and treated according to the same rules. A comparaison between two groups of children who were examined ten years apart has confirmed the changes which took place in the course of rheumatic fever during this period. The incidence of recidives recorded at admission has dropped considerably. Multiple recidives, too, have grown rarer. The incidence of the forms with cardiopathy at admission has dropped. This is, for the most part, due to the reduction in the number of recidives. The severity of cardiopathies has abated, too, and this goes irrespective of the number of previous attacks. The results of treatment in children with cardiopathy are identical in both groups. Treatment methods have not changed from the beginning to the ending of the study; there is a good ground for thinking that the advances observed are due principally to the secondary prevention and related, therefore, to improvements in the health education level, which leads to a recidive prevention better done than in the past.

Adolescent↗
PubMed2002

Acute rheumatic fever in a patient with glycogen storage disease type Ib: causal or coincidental simultaneous occurrence?

UNLABELLED: We report a Caucasian female who was diagnosed with glycogen storage disease type Ib (GSD-Ib) at the age of 4 months and whose clinical course was complicated by neutropenia and very frequent episodes of infection, including tonsillopharyngitis. Recurrent group A streptococcal infections resulted in multiple episodes of extremely high serum levels of antibodies to streptolysin O (5,000 IU/ml) and DNAse B (6,000 IU/ ml). At the age of 14 years she presented with carditis, migratory arthritis, fever, elevated erythrocyte sedimentation rate as well as serological evidence for recent streptococcal infection providing a diagnosis of acute rheumatic fever. CONCLUSION: the occurrence of these two very rare disorders in our patient may indicate that this association is not coincidental because neutrophil dysfunction in glycogen storage disease type Ib may have predisposed this patient to acute rheumatic fever due to increased susceptibility to group A streptococcal infections. aberrant glycogenolysis and gluconeogenesis, neutropenia and neutrophil dysfunction are regular findings in GSD-Ib. Neutropenia and neutrophil dysfunction in patients with GSD-Ib are due to defects in myeloid maturation, impaired neutrophil motility, defective chemotaxis and phagocytosis and diminished bactericidal activity resulting in recurrent bacterial infections.

Acute Disease↗
PubMedDate not supplied

[Rheumatic fever: a retrospective study of a case series of the last 20 years].

The incidence of rheumatic fever in the last twenty years in our ward is reviewed. A substantial decrease is noted; anyway a peak in the years '80-'86 is reported, accordingly literature. Carditis is a frequent manifestation, but its clinical impact is less severe than in the past. Arthritis may have an unusual feature. A good compliance to prophylaxis has been obtained by a strict follow-up.

Adolescent↗
PubMed1989

Evidence of inherited susceptibility of increased streptococcal adherence to pharyngeal cells of children with rheumatic fever.

The study included the members of 15 families, each having more than one sibling affected by rheumatic fever (RF). All the rheumatic individuals showed the sequelae of rheumatic carditis, but on clinical and laboratory evidence, the disease was inactive. Thirty normal unrelated individuals, having no rheumatic first-degree relatives, were studied as controls. The following investigations were carried out for all members: (1) history and clinical examination, (2) routine investigations of diagnosis, (3) HLA typing using 9-A, 15-B, 6-DR antigens, (4) adherence of group A streptococci to pharyngeal cells, an in vitro adherence assay. There were two types of strains; five RF-associated strains and two RF-unassociated strains. Statistical and genetic analysis revealed: (1) no significant difference between adherence of RF-associated and unassociated strains amongst controls; (2) significant increased avidity for adherence of RF-associated strains amongst rheumatic siblings compared to normal siblings and controls. There was no significant difference between the three groups using RF-unassociated strains; (3) HLA-haplotype concordance and 'N' measure showed that the avidity for adherence is probably inherited; (4) lod scores for linkage suggest a dominant susceptibility gene(s) closely linked to HLA and segregating in multiplex families.

Bacterial Adhesion↗
PubMed1989

[Rheumatic fever in a developing country in North Africa].

In a catchment area with population of approximately 60,000 in Libya for a period of two years and three months a group of 38 children aged 7-12 years with the diagnosis of rheumatic fever was followed up. An incidence of cca 60 attacks of rheumatic fever per 100,000 children per year was recorded. The clinical picture of primary attacks did not differ from the clinical picture of primary attacks in technically advanced countries in the sixties and also the development of the finding on the heart in rheumatic patients with penicillin prophylaxis was equally favourable.

Adolescent↗
PubMed1990

[Immunologic reactions with group-specific antigens of group A Streptococcus in rheumatic fever].

The levels of Group A streptococcal antigens, characterized by group specificity, incorporated in the immune complexes, were measured by enzyme immunoassay, and antibodies to group-specific polysaccharide were titered in patients with rheumatic fever of the minimal activity, running a protracted course. A statistically significant rise of these parameters was revealed in rheumatic patients as against normal subjects or patients with chronic tonsillitis with tonsillogenic cardiopathy. The diagnostic informativeness of these methods was found higher than that of antistreptolysin-O determination. The authors make a conclusion that signs of streptococcal infection persist in cases with the minimal activity of the rheumatic process and discuss rational antibiotic therapy of such patients. The described methods are recommended for the diagnosis and differential diagnosis of rheumatic fever of low activity.

Antigens, Bacterial↗
PubMed1985

A survey to evaluate the management of orthodontic patients with a history of rheumatic fever or congenital heart disease.

A survey concerning the orthodontic management of patients with a history of rheumatic fever or congenital heart disease was mailed to a random sample of 500 orthodontists throughout the United States. Two hundred thirty-two surveys were completed and returned. Analysis revealed that 88% of the respondents were aware that they should screen for patients with a history of rheumatic fever or congenital heart disease, only 11% used the antibiotic regimen recommended in 1977 by the American Heart Association (see Fig. 2), one half of the respondents thought it was necessary to provide antibiotic coverage during banding, and 38% deemed it necessary for debanding procedures which were likely to cause some degree of bleeding from the gingival sulcus. Only one half of the respondents would discontinue treatment if a condition of gingivitis developed which did not show signs of improvement, and only 70% provided medication for orthodontic procedures that could result in bacteremia. Furthermore, the results of this survey indicated that there was a great variation in the antibiotic regimen of orthodontic treatment for patients at risk of developing endocarditis and that there was a need to make the orthodontist more aware of the 1977 recommendations of the American Heart Association. Finally, a comparison between the year of graduation from an orthodontic program and the number of respondents who did not screen for or did not premedicate at-risk patients revealed a direct relationship. The earlier the education, the smaller the number of respondents who screened or premedicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗