| Acute rheumatic fever and poststreptococcal reactive arthritis reconsidered. | |
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MedLine Citation:
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PMID: 20150812 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: The incidence of acute rheumatic fever (ARF) in the United States and Western Europe is decreasing and postStreptococcal reactive arthritis (PSRA) is more prevalent. It is not clear whether PSRA is a forme fruste of ARF or a separate disease entity. Therefore, this review explores similarities and dissimilarities in initial symptoms and signs, disease course and underlying pathophysiologic mechanisms. RECENT FINDINGS: ARF and PSRA present differently. PSRA patients are generally older, have a longer interval between group A streptococcus infection and symptom onset, and respond less dramatically to salicylates than ARF patients. The course of ARF may be complicated by carditis and valvular heart disease. Echocardiographic studies in Caucasian adults with PSRA have revealed no increase in valvular heart disease. The course of PSRA is characterized by arthritis that, in contrast to ARF, is additive, nonmigratory and is frequently chronic. Factors of the host, the Streptococcus and the immune response involved in the development of PSRA are scarcely explored, hampering comparisons with ARF. SUMMARY: On the basis of the differences in clinical presentation and disease course, ARF and PSRA are separate disease entities. Development of validated diagnostic criteria for PSRA is mandatory to proceed with studies on pathophysiological mechanisms and treatment in PSRA. |
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Authors:
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Annette H M van der Helm-van Mil |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in rheumatology Volume: 22 ISSN: 1531-6963 ISO Abbreviation: Curr Opin Rheumatol Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-09 Completed Date: 2010-09-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000851 Medline TA: Curr Opin Rheumatol Country: United States |
Other Details:
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Languages: eng Pagination: 437-42 Citation Subset: IM |
Affiliation:
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Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. AvdHelm@lumc.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Arthritis, Reactive
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diagnosis*,
epidemiology*,
microbiology Diagnosis, Differential Humans Incidence Prevalence Rheumatic Fever / diagnosis*, epidemiology* Streptococcal Infections / diagnosis*, epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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