| Antiphospholipid syndrome and rheumatic fever: a case spanning three decades of changing concepts and common immunological mechanisms. | |
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MedLine Citation:
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PMID: 21669913 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We present a case of primary antiphospholipid syndrome (APS), initially diagnosed as acute rheumatic fever, resulting in severe mitral valve incompetence. This case raises questions of the specificity of the Jones diagnostic criteria for rheumatic fever in a population where it is infrequently encountered. There are similarities in clinical, pathological and echocardiographic presentations between rheumatic fever and APS, in addition to common immunological mechanisms. Our case highlights the possibility that rather than rheumatic fever being primarily responsible for her recurrent attacks of chorea and arthritis, the streptococcal infections in our patient occurred either in the setting of underlying antiphospholipid antibodies ('second hit' phenomenon), or may have triggered the development of pathogenic antibodies (molecular mimicry), subsequently leading to the clinical evolution of APS. During the three decades of our patient and her recurrent problems, there has been an evolving knowledge of the mechanisms of APS and rheumatic fever, allowing us to extend our understanding beyond symptoms and syndromes, to a better realization of the underlying immunological relationship between the two. |
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Authors:
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R Alcock; M Elsik; C Yiannikas; J Yiannikas |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-13 |
Journal Detail:
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Title: Lupus Volume: - ISSN: 1477-0962 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204265 Medline TA: Lupus Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Concord Hospital, University of Sydney, Sydney, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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