24,537 results match your criteria Acute Rheumatic Fever


Polymyositis and covid-19: A morbide association (a case report).

Ann Med Surg (Lond) 2021 Aug 26;68:102598. Epub 2021 Jul 26.

Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

The COVID-19 pandemic and its impact on health systems had a significant effect on the management of inflammatory diseases in the long term and myopathies could be signs of COVID-19, making it difficult to diagnose the cause and effect relationship. An unvaccinated 62-year-old female patient followed for polymyositis was tested positive for COVID-19 on polymerase chain reaction (PCR) of nasopharyngeal swab revealed by dyspnea and rhinorrhea with fever and pulmonary involvement of 75%. She had an enlarged left ventricle with complete left branch block, inaugural diabetes mellitus with ketosis, kidney dysfunction, and inflammatory syndrome. Read More

View Article and Full-Text PDF

Group A streptococcal pharyngitis: A practical guide to diagnosis and treatment.

Paediatr Child Health 2021 Aug 28;26(5):319-320. Epub 2021 Jul 28.

Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario, Canada.

Group A (GAS) pharyngitis is a common clinical syndrome in primary care, yet controversy remains regarding the best approach to diagnosis and treatment, including the benefits of antibiotics. Children who are likely to have GAS pharyngitis based on history or physical examination should have a throat swab and, when positive, be treated with amoxicillin or penicillin. The disproportionate burden of acute rheumatic fever in Indigenous populations in Canada and special considerations for testing and treatment are discussed. Read More

View Article and Full-Text PDF

Mapping Autoantibodies in Children With Acute Rheumatic Fever.

Front Immunol 2021 15;12:702877. Epub 2021 Jul 15.

School of Medical Sciences, The University of Auckland, Auckland, New Zealand.

Background: Acute rheumatic fever (ARF) is a serious sequela of Group A (GAS) infection associated with significant global mortality. Pathogenesis remains poorly understood, with the current prevailing hypothesis based on molecular mimicry and the notion that antibodies generated in response to GAS infection cross-react with cardiac proteins such as myosin. Contemporary investigations of the broader autoantibody response in ARF are needed to both inform pathogenesis models and identify new biomarkers for the disease. Read More

View Article and Full-Text PDF

A permutation-based approach for heterogeneous meta-analyses of rare events.

Stat Med 2021 Jul 30. Epub 2021 Jul 30.

Research and Development, Cytel Inc., Cambridge, Massachusetts, USA.

The increasingly widespread use of meta-analysis has led to growing interest in meta-analytic methods for rare events and sparse data. Conventional approaches tend to perform very poorly in such settings. Recent work in this area has provided options for sparse data, but these are still often hampered when heterogeneity across the available studies differs based on treatment group. Read More

View Article and Full-Text PDF

Descriptive analysis of group A in skin swabs and acute rheumatic fever, Auckland, New Zealand, 2010-2016.

Lancet Reg Health West Pac 2021 Mar 5;8:100101. Epub 2021 Feb 5.

Department of Public Health, University of Otago, 23a Mein Street, Newtown 6021, Wellington, 6021, New Zealand.

Background: Group A (GAS) can trigger an immune-mediated response resulting in acute rheumatic fever (ARF). Historically, ARF has been considered a consequence of preceding GAS pharyngitis, but increasing evidence suggests that GAS skin infections may be a driver. Data on the primary care burden of GAS skin infection are limited. Read More

View Article and Full-Text PDF

COVID-19 infection among autoimmune rheumatic disease patients: Data from an observational study and literature review.

J Autoimmun 2021 Jul 16;123:102687. Epub 2021 Jul 16.

Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Medical Sciences/Immunology, Academy of Athens, Athens, Greece.

The impact of SARS-CoV-2 infection in patients with autoimmune/auto-inflammatory rheumatic diseases (AARD) under immunomodulatory treatment has been a focus of interest during the COVID-19 pandemic. In this observational study, demographic data, disease related features and comorbidities, COVID-19 manifestations and outcome as well as antibody responses to SARS-CoV-2 were recorded among 77 consecutive patients with underlying AARD infected by SARS-CoV-2. Analysis of data was performed using univariate and multivariate models. Read More

View Article and Full-Text PDF

Non-infectious thrombotic endocarditis associated with chronic rheumatic heart disease and disseminated tuberculosis.

Autops Case Rep 2021 6;11:e2021269. Epub 2021 May 6.

Post Graduate Institute of Medical Education and Research, Department of Cardiology, Chandigarh, India.

Rheumatic heart disease is still common in developing countries and requires prompt intervention to prevent chronic complications. Vegetations in rheumatic heart disease might be due to acute episodes of rheumatic fever itself or due to either infective endocarditis (IE) or Non-infectious thrombotic endocarditis (NITE). Each form of vegetations has specific pathological characteristics on gross and microscopic examination. Read More

View Article and Full-Text PDF

The combined detection of autoantibody characteristics in systemic lupus erythematosus.

Am J Transl Res 2021 15;13(6):7242-7248. Epub 2021 Jun 15.

Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong First Medical University Jinan 250013, Shandong Province, China.

Objective: To investigate the combined detection of the autoantibody characteristics in systemic lupus erythematosus (SLE).

Methods: 105 SLE patients admitted to our hospital from May 2019 to September 2020 were placed in the SLE examination group (the SE group), 110 patients with rheumatic diseases admitted to our hospital during the same period were placed in the disease control group (the DC group), and 100 healthy people who came to our hospital for physical examinations during the same time period were placed in the healthy control group (the HC group). The SLE patients' clinical data were recorded. Read More

View Article and Full-Text PDF

Early diagnosis of acute rheumatic fever and rheumatic heart disease as part of a secondary prevention strategy: Narrative review.

J Paediatr Child Health 2021 Jul 23. Epub 2021 Jul 23.

Department of Public Health, University of Otago, Wellington, New Zealand.

Acute rheumatic fever (ARF) and its sequela rheumatic heart disease (RHD) remain significant causes of morbidity and mortality. In New Zealand, ARF almost exclusively affects Indigenous Māori and Pacific children. This narrative review aims to present secondary interventions to improve early and accurate diagnosis of ARF and RHD, in order to minimise disease progression in New Zealand. Read More

View Article and Full-Text PDF

The combined prevalence of classified rare rheumatic diseases is almost double that of ankylosing spondylitis.

Orphanet J Rare Dis 2021 07 22;16(1):326. Epub 2021 Jul 22.

Department of Rheumatology, Spitalzentrum-Centre hospitalier, Biel-Bienne, Switzerland.

Background: Rare diseases (RDs) affect less than 5/10,000 people in Europe and fewer than 200,000 individuals in the United States. In rheumatology, RDs are heterogeneous and lack systemic classification. Clinical courses involve a variety of diverse symptoms, and patients may be misdiagnosed and not receive appropriate treatment. Read More

View Article and Full-Text PDF

Hypomagnesaemia causing functional hypoparathyroidism in rheumatic mitral stenosis leading to sudden cardiac arrest in a young woman.

BMJ Case Rep 2021 Jul 19;14(7). Epub 2021 Jul 19.

Cardiology, Nitte University KS Hegde Medical Academy, Mangalore, Karnataka, India

A 23-year-old young woman with a known history of valvular heart disease of rheumatic origin, post balloon mitral valvotomy 5 years ago, presented with fever, palpitations and breathlessness. ECG showed atrial fibrillation with fast ventricular rate. A 2D transthoracic echocardiography showed severe restenosis of mitral valve and moderate left ventricular dysfunction. Read More

View Article and Full-Text PDF

The "Cairo Accord"- Towards the Eradication of RHD: An Update.

Front Cardiovasc Med 2021 2;8:690227. Epub 2021 Jul 2.

Aswan Heart Centre, Aswan, Egypt.

Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference "Rheumatic Heart Disease: from Molecules to the Global Community," experts from 21 countries formulated an approach for addressing the problem of RHD: "The Cairo Accord on Rheumatic Heart Disease. Read More

View Article and Full-Text PDF

Persisting burden and challenges of rheumatic heart disease.

Eur Heart J 2021 Jul 15. Epub 2021 Jul 15.

Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Rheumatic heart disease (RHD) is the result of episodes of acute rheumatic fever with valvular (and other cardiac) damage caused by an abnormal immune response to group A streptococcal infections, usually during childhood and adolescence. As a result of improved living conditions and the introduction of penicillin, RHD was almost eradicated in the developed world by the 1980s. However, being a disease of poverty, its burden remains disproportionately high in the developing world, despite being a fundamentally preventable disease. Read More

View Article and Full-Text PDF

Management of rheumatic aortic valve disease using the Ozaki procedure with autologous pericardium: a case report.

Eur Heart J Case Rep 2021 Jun 23;5(6):ytab170. Epub 2021 Jun 23.

University of Bristol, Medical School, Senate House, Tyndall Ave, Bristol BS8 1TH, UK.

Background: Rheumatic valve disease (RVD) is the most common cause of cardiovascular death in low-middle income nations. Surgical aortic valve (AV) interventions for RVD, especially in children, have proven problematic with graft failure, relapse, and poor compliance with anticoagulation. A novel technique involving neocuspidization of the aortic annulus using autologous pericardium to construct new AV leaflets (the Ozaki procedure) has shown promising outcomes in children with congenital AV disease; however, there are no previous recorded cases using this technique in children with RVD. Read More

View Article and Full-Text PDF

Macrophage activation syndrome: A diagnostic challenge (Review).

Exp Ther Med 2021 Aug 24;22(2):904. Epub 2021 Jun 24.

Internal Medicine Department, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.

Macrophage activation syndrome (MAS) represents an acute and severe inflammatory syndrome, idiopathic (primary) or secondary to infections, rheumatic diseases, malignancies, or drugs. MAS is underdiagnosed, being confused with sepsis, adverse effects of anti-arthritic drugs or exacerbated symptoms of evolving rheumatologic or infectious diseases. Because of the late diagnosis, most patients do not benefit from effective therapy, leading to death. Read More

View Article and Full-Text PDF

New Insights into Chikungunya Virus Infection and Pathogenesis.

Annu Rev Virol 2021 Jul 13. Epub 2021 Jul 13.

Biology of Emerging Virus Team, INSERM U944, CNRS UMR 7212, Institut de Recherche Saint-Louis, Université de Paris, Hôpital Saint-Louis, 75010 Paris, France; email:

Chikungunya virus (CHIKV) is a re-emerging mosquito-borne alphavirus responsible for major outbreaks of disease since 2004 in the Indian Ocean islands, South east Asia, and the Americas. CHIKV causes debilitating musculoskeletal disorders in humans that are characterized by fever, rash, polyarthralgia, and myalgia. The disease is often self-limiting and nonlethal; however, some patients experience atypical or severe clinical manifestations, as well as a chronic rheumatic syndrome. Read More

View Article and Full-Text PDF

Identification of Group A Streptococcus Genes Directly Regulated by CsrRS and Novel Intermediate Regulators.

mBio 2021 Jul 13:e0164221. Epub 2021 Jul 13.

Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.

Adaptation of group A Streptococcus (GAS) to its human host is mediated by two-component systems that transduce external stimuli to regulate bacterial physiology. Among such systems, CsrRS (also known as CovRS) is the most extensively characterized for its role in regulating ∼10% of the GAS genome, including several virulence genes. Here, we show that extracellular magnesium and the human antimicrobial peptide LL-37 have opposing effects on the phosphorylation of the response regulator CsrR by the receptor kinase CsrS. Read More

View Article and Full-Text PDF

What Lies Ahead for Young Hearts in the 21 Century - Is It Double Trouble of Acute Rheumatic Fever and Kawasaki Disease in Developing Countries?

Front Cardiovasc Med 2021 24;8:694393. Epub 2021 Jun 24.

Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Rheumatic heart disease (RHD), the principal long-term sequel of acute rheumatic fever (ARF), has been a major contributor to cardiac-related mortality in general population, especially in developing countries. With improvement in health and sanitation facilities across the globe, there has been almost a 50% reduction in mortality rate due to RHD over the last 25 years. However, recent estimates suggest that RHD still results in more than 300,000 deaths annually. Read More

View Article and Full-Text PDF

Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis.

Front Cardiovasc Med 2021 23;8:676098. Epub 2021 Jun 23.

Department of Medicine, Universidade Positivo, Curitiba, Brazil.

Secondary prophylaxis of rheumatic heart diseases is efficient in reducing disease recurrence, heart damage, and cardiac impairment. We aimed to monitor the clinical evolution of a large Brazilian cohort of rheumatic patients under prolonged secondary prophylaxis. From 1986 to 2018, a cohort of 593 patients with rheumatic fever was followed every 6 months by the Reference Center for the Control and Prevention of Rheumatic Fever and Rheumatic Cardiopathy (CPCFR), Paraná, Brazil. Read More

View Article and Full-Text PDF

Refining "Long-COVID" by a Prospective Multimodal Evaluation of Patients with Long-Term Symptoms Attributed to SARS-CoV-2 Infection.

Infect Dis Ther 2021 Sep 10;10(3):1747-1763. Epub 2021 Jul 10.

Rheumatology Department, Centre Hospitalier Universitaire de Strasbourg, 1 Avenue Molière, 67098, Strasbourg, France.

Introduction: COVID-19 long-haulers, also decribed as having "long-COVID" or post-acute COVID-19 syndrome, represent 10% of COVID-19 patients and remain understudied.

Methods: In this prospective study, we recruited 30 consecutive patients seeking medical help for persistent symptoms (> 30 days) attributed to COVID-19. All reported a viral illness compatible with COVID-19. Read More

View Article and Full-Text PDF
September 2021

Native Valve Infective Endocarditis Caused by in an Immunocompetent Host: The First Case in Asia and Literature Review in Asia and Australia.

Case Rep Infect Dis 2021 21;2021:9981286. Epub 2021 Jun 21.

Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Background: Infective endocarditis caused by the dimorphic fungus is extremely rare, occurring predominantly in individuals with prosthetic heart valves and HIV infection. To our knowledge, no case of native valve endocarditis has been reported in Asia. . Read More

View Article and Full-Text PDF

Preventive interventions to reduce the burden of rheumatic heart disease in populations at risk: a systematic review protocol.

Syst Rev 2021 07 8;10(1):200. Epub 2021 Jul 8.

Department of Epidemiology and Global Health, Umeå University, SE 901 87, Umeå, Sweden.

Background: Rheumatic heart disease is preventable, yet associated with significant health burden, mostly in low-resourced settings. It is prevalent among children and young adults living in impoverished areas. Primordial, primary, and secondary preventive measures have been recommended through health interventions and comprehensive programmes, although most implemented interventions are the high-resourced settings. Read More

View Article and Full-Text PDF

Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran.

BMC Infect Dis 2021 Jul 7;21(1):656. Epub 2021 Jul 7.

Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran.

Background: Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Read More

View Article and Full-Text PDF

Incidence and clinical characteristics of acute rheumatic fever in Turkey: Results of a nationwide multicentre study.

J Paediatr Child Health 2021 Jul 6. Epub 2021 Jul 6.

Department of Pediatric Cardiology, Çukurova University School of Medicine, Adana, Turkey.

Aim: To evaluate the incidence and clinical features of acute rheumatic fever (ARF) in Turkey, following the revised Jones criteria in 2015.

Methods: This multicentre study was designed by the Acquired Heart Diseases Working Group of the Turkish Pediatric Cardiology and Pediatric Cardiac Surgery Association in 2016. The data during the first attack of 1103 ARF patients were collected from the paediatric cardiologists between 1 January 2016 and 31 December 2016. Read More

View Article and Full-Text PDF

Uncontrollable movements of right upper and lower extremities in a child: A diagnostic puzzle.

J Am Coll Emerg Physicians Open 2021 Aug 30;2(4):e12497. Epub 2021 Jun 30.

Department of Pediatrics The Brooklyn Hospital Center New York USA.

We describe a case of a 9-year-old child who presented with uncontrollable, involuntary movements associated with a recent streptococcal infection and echocardiographic evidence of valvulitis. These findings are consistent with the diagnosis of Sydenham's chorea, a rare but important movement disorder and one of the major "Jones criteria" for the diagnosis of acute rheumatic fever. Because of its rarity, patients with Sydenham's chorea often are misdiagnosed as having a behavioral or psychiatric illness. Read More

View Article and Full-Text PDF

Health system costs of rheumatic heart disease care in South Africa.

BMC Public Health 2021 07 3;21(1):1303. Epub 2021 Jul 3.

Health Economics Unit, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

Background: Rheumatic Heart Disease (RHD) is a disease of poverty that is neglected in developing countries, including South Africa. Lack of adequate evidence regarding the cost of RHD care has hindered national and international actions to prevent RHD related deaths. The objective of this study was to estimate the cost of RHD-related health services in a tertiary hospital in the Western Cape, South Africa. Read More

View Article and Full-Text PDF

COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey.

Rheumatol Int 2021 09 2;41(9):1601-1605. Epub 2021 Jul 2.

Niruj Rheumatology Clinic, 209 Rajvi Complex, Rambaug, Ahmedabad, 380008, Gujarat, India.

Patients with a systemic autoimmune rheumatic disease (AIRD) are vulnerable to SARS Cov-2 infection. Vaccination against this infection can prevent the patients from developing severe disease. But vaccine hesitancy in this group can emerge as a hurdle. Read More

View Article and Full-Text PDF
September 2021

Antibody responses to collagen peptides and streptococcal collagen-like 1 proteins in acute rheumatic fever patients.

Pathog Dis 2021 Jul;79(6)

School of Medical Sciences, The University of Auckland, Auckland, New Zealand.

Acute rheumatic fever (ARF) is a serious post-infectious immune sequelae of Group A streptococcus (GAS). Pathogenesis remains poorly understood, including the events associated with collagen autoantibody generation. GAS express streptococcal collagen-like proteins (Scl) that contain a collagenous domain resembling human collagen. Read More

View Article and Full-Text PDF

Panniculitis as a manifestation of metal-associated autoimmune/inflammatory syndrome induced by adjuvants: a case-based review.

Rheumatol Int 2021 Jun 27. Epub 2021 Jun 27.

V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is associated with a hyperergic response of the immune system. The spectrum of clinical changes in ASIA is extensive and difficult to diagnose. Panniculitis is a heterogeneous group of diseases characterized by lesions of the adipose tissue. Read More

View Article and Full-Text PDF

Group A streptococcal antigen exposed rat model to investigate neurobehavioral and cardiac complications associated with post-streptococcal autoimmune sequelae.

Animal Model Exp Med 2021 Jun 8;4(2):151-161. Epub 2021 Apr 8.

School of Science & Technology University of New England Armidale NSW Australia.

Background: The neuropsychiatric disorders due to post-streptococcal autoimmune complications such as Sydenham's chorea (SC) are associated with acute rheumatic fever and rheumatic heart disease (ARF/RHD). An animal model that exhibits characteristics of both cardiac and neurobehavioral defects in ARF/RHD would be an important adjunct for future studies. Since age, gender, strain differences, and genotypes impact on the development of autoimmunity, we investigated the behavior of male and female Wistar and Lewis rat strains in two age cohorts (<6 weeks and >12 weeks) under normal husbandry conditions and following exposure to group A streptococcus (GAS). Read More

View Article and Full-Text PDF