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Rheumatic/autoimmune

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[1] Rheumatic fever is an inflammatory disease that occurs following a Group A streptococcal infection, (such as strep throat or scarlet fever). Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain,[2] the illness typically develops two to three weeks after a streptococcal infection. Acute rheumatic fever commonly appears in children between the ages of 5 and 15, with only 20% of first-time attacks occurring in adults.[2] The illness is so named because of its similarity in presentation to rheumatism.[3]

Diagnosis of Rheumatic fever:

Rheumatic heart disease at autopsy with characteristic findings (thickened mitral valve, thickened chordae tendineae, hypertrophied left ventricular myocardium).

Modified Jones criteria were first published in 1944 by T. Duckett Jones, MD.[4] They have been periodically revised by the American Heart Association in collaboration with other groups.[5] According to revised Jones criteria, the diagnosis of rheumatic fever can be made when two of the major criteria, or one major criterion plus two minor criteria, are present along with evidence of streptococcal infection. Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever. [6][7][8]

Major criteria:

  • Migratory polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
  • Carditis: inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
  • Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
  • Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle. This rash never starts on the face and it is made worse with heat.
  • Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms. This can occur very late in the disease.

Minor criteria:

References

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  1. ^ "Rheumatic Fever: eMedicine Emergency Medicine". Emedicine.medscape.com. Retrieved 2010-03-09.
  2. ^ a b c Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 403-406 ISBN 978-1-4160-2973-1
  3. ^ "rheumatic fever" at Dorland's Medical Dictionary
  4. ^ Jones TD (1944). "The diagnosis of rheumatic fever". JAMA. 126: 481–4.
  5. ^ Ferrieri P; Jones Criteria Working, Group (2002). "Proceedings of the Jones Criteria workshop". Circulation. 106 (19): 2521–3. doi:10.1161/01.CIR.0000037745.65929.FA. PMID 12417554. {{cite journal}}: |first2= has generic name (help)
  6. ^ Steven J Parrillo, DO, FACOEP, FACEP. "eMedicine — Rheumatic Fever". Retrieved 2007-07-14.{{cite web}}: CS1 maint: multiple names: authors list (link)
  7. ^ "Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association". JAMA. 268 (15): 2069–73. 1992. PMID 1404745.
  8. ^ Saxena, Anita (2000). "Diagnosis of rheumatic fever: Current status of Jones criteria and role of echocardiography". Indian Journal of Pediatrics. 67 (4): 283–6. doi:10.1007/BF02758174. PMID 11129913.
  9. ^ http://www.utmb.edu/Pedi_Ed/CoreConceptsOfPediatrics/Cardiology/page_40.htm
  10. ^ "Henoch-Schönlein Purpura". familydoctor.org. 1998-08-01. Retrieved 2010-03-09.
  11. ^ https://health.google.com/health/ref/Kawasaki+disease
  12. ^ "Systemic Lupus Erythematosus: eMedicine Rheumatology". Emedicine.medscape.com. 2009-01-22. Retrieved 2010-03-09.
  13. ^ "Polyarteritis nodosa: MedlinePlus Medical Encyclopedia". Nlm.nih.gov. Retrieved 2010-03-09.
  14. ^ "Temporal Arteritis: eMedicine Emergency Medicine". Emedicine.medscape.com. 2009-09-08. Retrieved 2010-03-09.
  15. ^ https://www.vasculitisfoundation.org/polymyalgiarheumatica
  16. ^ https://www.vasculitisfoundation.org/wegenersgranulomatosis
  17. ^ Foundation for Sarcoidosis Research. "FSR - Symptoms of Sarcoidosis". Stopsarcoidosis.org. Retrieved 2010-03-09.
  18. ^ "Sarcoidosis: eMedicine Dermatology". Emedicine.medscape.com. 2009-09-08. Retrieved 2010-03-09.