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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rheumatic fever has decreased in frequency and severity, but the disease has not been eradicated in this country, especially in low socioeconomic populations. Carditis is less common, and changes in the frequency of other rheumatic manifestations such as chorea has made the clinical diagnosis more difficult. Streptococcal antibody tests are still the most useful laboratory aid, but care must be taken against overinterpretation. The search for the answer to the pathogenesis puzzle continues. Until the nature of the disease is better understood, it is unlikely that rheumatic fever will be eradicated. In the meantime, however, the incidence of the disease can be reduced further by improved medical care for deprived populations.
Arthritis Rheum 1977 Mar
PMID:The changing picture of rheumatic fever. 26 14

A study of rheumatic fever (RF) in Finland and Sweden was carried out by examining (a) the patients with RF in two hospitals in Helsinki, Finland during the years 1969-72, (b) the case reports of RF patients in Uppsals hospital region (UHR) in Sweden during the years 1968-69. In Helsinki there were 22 and 2n UHR 16 patients with an acceptably certain diagnosis of RF. Of the five "major manifestations" according to Jones' revised criteria (Circulation, 32: 664, 1965), carditis and polyarthritis were the most valuable diagnostic criteria, whereas only 8 cases of the whole material had erythema marginatum. The two remaining criteria, chorea and subcutaneous nodules, have lost their diagnostic value, since they are extremely rare nowadays. The diagnosis of RF was substantially influenced by arthritis associated with Yersinia enterocolitica infection. Some of the patients with YA met completely the Jones revised criteria for the diagnosis of RF. The symptomatology of Yersinia arthritis (YA) and that of RF are similar in some cases it is impossible to separate then even on the basis of serological tests. Diagnostic criteria should therefore be viewed against the geographical distribution of the disease. In addition to the required Jones' criteria, we concluded that at least in Sweden and Finland, in order to be categorized under RF, a patient must demonstrate clinical and serological evidence of acute streptococcal infection and, furthermore, Yersinia infection must be excluded.
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PMID:Rheumatic fever and Yersinia arthritis. Criteria and diagnostic problems in a changing disease pattern. 116 82

Atrioventricular conduction was quantitatively evaluated in 118 children with acute rheumatic fever. The mean PR index in children with acute rheumatic fever, 1.06 +/- 0.38, was significantly higher than normal children or children who had febrile illness of nonrheumatic or nonstreptococcal origin (P is less than .001). Among 35 children with rheumatic fever and an abnormal PR index, the disease presented as carditis in 21, arthritis in ten, and chorea in four. The mean PR index and the frequency distribution of abnormal PR indices were significantly higher in children with carditis (P is less than .001). Five children who initially had an abnormal PR index and arthritis or chorea subsequently developed carditis. These observations suggest that children with acute rheumatic fever and abnormal PR index warrant close observation for possible clinical evidence of myocardial involvement during subsequent course of the illness.
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PMID:Atrioventricular conduction in children with acute rheumatic fever. 127 96

The diagnosis of rheumatic fever (RF) continues to be a difficult one in Pediatrics, mainly because of the polymorphism of its clinical presentation and the lack of specific laboratory test. Among the Jones' major criteria, arthritis is the most frequent and the least specific. Ninety three children with RF who presented 117 flares of the disease were studied in the Department of Pediatrics, Escola Paulista de Medicina, between Dec. 1989 and Dec. 1991. The presence of arthritis was defined as an inclusion criterion. The diagnosis was based on history, physical and laboratory examinations (Modified Jones' Criteria). The mean age was 10 years and the sex ratio was 1 male: 1.4 female. In 45% of the flares, arthritis was the only major criterion. In 44% there were arthritis and carditis, in 7% arthritis and chorea and in 4% arthritis, carditis and chorea. In 64% of the flares the pattern of articular involvement was migratory and in 36% addictive. Polyarthritis and oligoarthritis were observed respectively in 64% and 36%. Monoarthritis was reported in 3%. The definitive diagnosis of RF with atypical articular involvement only was possible in the presence of carditis or chorea. The authors conclude that physicians should be aware of the atypical involvement observed in some cases of RF, specially when arthritis is the only major criterion.
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PMID:[Rheumatic fever: atypical joint manifestations]. 134 Mar 79

Chorea as a manifestation of SLE is infrequent (1% of all cases of SLE). A new case is reported herein. The patient, a seventeen-year-old female, was admitted with a one-week history of choreic movements of the left half of the body and arthritis of both wrists. Biologic findings confirmed the diagnosis of SLE with presence of an antiprothrombinase circulating anticoagulant. Findings upon cerebral CT scan and magnetic resonance imaging were normal. Clinical symptoms worsened despite corticosteroids in a daily dosage of 1 mg/kg with three pulses of 800 mg methylprednisolone. High-dose neuroleptic therapy was given and three plasma exchanges were performed. A dramatic improvement in clinical symptoms and biological anomalies occurred and persisted during follow-up which now exceeds one year. The lack of MRI anomalies suggests that the pathogenesis of SLE-associated chorea involves functional neurone activation by immune complexes; the dramatic effectiveness of plasma exchanges may obviate the need for using immunosuppressant agents in patients who fail to respond to corticosteroids.
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PMID:[Lupus chorea revealing. Study in magnetic resonance imaging. Success of plasma exchanges after resistance to pulsed cortisone]. 141 Dec 10

An epidemiological study of rheumatic fever (RF) has been done. Incidence and prevalence of RF observed in Monza Hospital from 1964 to 1990 and in Como Hospital from 1980 to 1990 both show a progressive reduction. An exception to this trend was observed in 1986 in Monza in 1985 in Como. The percentage of carditis in pediatric age is high (60-70%), often associated with arthritis and chorea. However carditis clinical picture seems nowadays less severe, probably because in the past the diagnosis was delayed. Sice 1980 no death were observed due to RF or related cardiac involvement. Relapses and residual valvulopathies are significantly reduced only when penicillin prophylaxis was correctly performed.
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PMID:[Rheumatic fever from 1960's to 1990's. Case records in 2 hospitals of the Lombardian area]. 146 81

Between 1977-1989, 143 children with acute rheumatic fever were hospitalized here. In contrast to western countries, there has been no decline in the absolute number of hospitalizations for this disease here. A high prevalence of rheumatic fever was found among Bedouins and non-Ashkenazi Jews (2.5 and 1.5 times greater than the expected incidence, respectively). The affected children were usually from large families and lived in crowded conditions. Recurrences of rheumatic fever were more frequent among girls, and they were affected at an older age. The manifestations, in order of frequency, were arthritis, carditis and chorea. Chorea was found only among girls.
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PMID:[Rheumatic fever among children in the Negev]. 157 72

During a 5-year period ending in December 1989, 73 episodes of acute rheumatic fever in 67 children aged 4-14 years were prospectively studied to ascertain the clinical profile of the disease in initial attacks and recurrences, and to compare the findings with those from other countries. Among 51 children with a first episode of acute rheumatic fever, 76% had arthritis and 43% had carditis. In 22 children with recurrences, arthritis was present in 45% and carditis in 91%. Carditis was more severe among the cases with recurrences. Mitral insufficiency was the most common valvular lesion, but no case of mitral stenosis was detected. Chorea, subcutaneous nodules, and Erythema marginatum were relatively rare. The demographic, clinical and laboratory findings of this study resemble those from Western countries, in contrast with data from tropical countries. Efforts aimed at prompt recognition and adequate treatment of streptococcal pharyngitis and maintenance of anti-streptococcal chemoprophylaxis would be rewarding in reducing the incidence of this disease and its sequelae.
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PMID:Acute rheumatic fever during childhood in Saudi Arabia. 171 21

To assess the diagnostic importance of B-cellular marker demonstration with the aid of D8/17 monoclonal antibodies in arthritis and other manifestations of rheumatic fever, 175 persons were examined. Of these, 117 patients presented with rheumatic fever and rheumatic heart disease. The marker was identified in 88.9% of the patients and in 10% of the healthy subjects entering the control group. The rate of the marker demonstration did not depend on the clinical manifestations of rheumatic fever (arthritis, carditis, chorea), the disease phase, the disease standing or the intensity of heart damage. It is concluded that marker demonstration in rheumatic fever is of paramount diagnostic value, particularly in little manifest processes.
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PMID:[The diagnostic significance of the surface B-cell marker carrier state in arthritis and other manifestations of rheumatic fever]. 188 18

A retrospective study of 42 children with acute rheumatic fever admitted to Hospital Universiti Sains Malaysia from April 1985 to March 1989 was undertaken to assess the clinical, laboratory, echocardiographic aspects and outcome. The ages of the children ranged from 5 years 9 months to 11 years 11 months. There was no significant sex difference. 69.4% were admitted between November and April with a seasonal low between May and August. Sixteen children (38.1%) were hospitalised for recurrence of rheumatic fever. Carditis was the commonest manifestation and was seen in 28 (66.6%) children, followed by arthritis in 24 (57.1%), and chorea in 3 (7.1%). Echocardiography detected abnormalities in 24 out of 35 cases and the most common echocardiographic findings were poor coaptation of mitral valve (ten) left ventricular dilatation (ten), thickened mitral valve cusps (seven) and pericardial effusion (seven). In those children followed up, there were 2 recurrences while on secondary prophylaxis and complete recovery was seen only in 11 (26.9%).
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PMID:A clinical, laboratory and echocardiographic profile of children with acute rheumatic fever. 225 35


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