Acute Rheumatic Fever Cases Presented with Enthesitis: A Different View on Acute Rheumatic Fever

Vildan Güngörer; Ahmet Sert; Şükrü  Arslan

doi:10.21765/pprjournal.975657

Research Article

Acute Rheumatic Fever Cases Presented with Enthesitis: A Different View on Acute Rheumatic Fever

Year 2021, Volume: 9 Issue: 3, 120 - 125, 31.12.2021

Vildan Güngörer Ahmet Sert Şükrü Arslan

https://doi.org/10.21765/pprjournal.975657

Abstract

Background: Acute rheumatic fever (ARF) is a non-suppurative inflammatory disease that develops after group A Beta hemolytic streptococcal pharyngitis, primarily involving the heart, joint, central nervous system, skin and subcutaneous tissue. Today, Jones criteria; that were modified in 2015, are used for diagnosis. Our aim in this study is to examine the patients diagnosed with acute rheumatic fever in our clinic and presented with enthesitis.
Methods: The type of study is case report. Five patients who were admitted to the Pediatric Rheumatology Clinic of Selcuk University Faculty of Medicine were diagnosed with acute rheumatic fever and presented with enthesitis, between 2017- 2019 were examined retrospectively. Their demographic, clinical laboratory and echocardiographic data were examined. The presence of enthesitis in all patients was established with one or more of the options of clinical examination, ultrasonography, magnetic resonance imaging, and/or orthopedics opinion.
Results: While the clinic of the patients improved with the treatment for enthesitis, acute phase reactants did not fall and additional clinical findings appeared. Our observations suggested that acute rheumatic fever could apply to us not only with arthritis and arthralgia, but also with the enthesitis clinic. Therefore, we think that if the laboratory data are compatible among the differential diagnoses in patients presenting with enthesitis, acute rheumatic fever should also be considered, and careful physical examination and echocardiography should be performed for this purpose.
Conclusion: In relation to the pathogenesis of the rheumatological diseases, new clinical situations are emerging day by day, and in this way, the diseases are better understood and classified. In conclusion, we think that ARF can be encountered not only with arthritis and arthralgia but also with enthesitis clinics, and echocardiographic imaging should not be ignored in patients with enthesitis clinic who have high acute phase reactants and who do not meet the enthesitis-related juvenile idiopathic arthritis criteria.

Keywords

Acute rheumatic fever, arthralgia, arthritis, carditis, enthesitis

References

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4. Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005; 366:155–168.
5. Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 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 1992; 268:2069– 2073.
6. World Health Organization. Strategy for controlling rheumatic fever/rheumatic heart disease, with emphasis on primary prevention: memorandum from a joint WHO/ISFC meeting. Bull World Health Organ 1995; 73:583–587
7. Carapetis JR, Brown A, MAguire G, Walsh W, Noonan S, Thompson D. The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2nd ed. Sydney: Heart Foundation and Cardiac Society of Australia and New Zealand, 2012.
8. Tani LY, Veasy G, Minich L, Shaddy RE. Rheumatic fever in children younger than 5 years: Is the presentation different? Pediatrics 2003; 112: 1065-8.
9. Wang C, Liu C, Li Y, Liu M. Adult onset acute rheumatic fever. Possible resurgence in southern Taiwan. J Clin Rheumatol 2005; 11: 146-9.
10. Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones criteria for the diagnosis of the rheumatic fever in the era of Doppler echocardiography: A scientific statement of the American Heart Association. Circulation 2015; 131:1806-18.
11. Tibazarwa K, Volmink J, Mayosi B. Incidence of acute rheumatic fever in the world: a systematic review of population-based studies. Heart 2008; 94:1534-40.
12. Köksal AO, Gültekin Soylu A, Özdemir O. Akut Romatizmal Ateş. Turkish J Pediatr Dis 2016; 4: 283-296.
13. Orün UA, Ceylan O, Bilici M, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012; 171: 361-8.
14. Madden S, Kelly L. Update on acute rheumatic fever; it stil exists in remote communities. Can Fam Physician 2009; 55:475-8.
15. Narin N, Mutlu F, Argun M, et al. Incidence and clinical features of acute rheumatic fever in Kayseri, Central Anatolia 1998-2011. Cardiol Young 2015; 25:745-51.
16. Dajani AS, Ayooub E, Bierman FZ, et al. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young the American Heart Association. Guidelines for the diagnosis of rheumatic fever. Jones criteria, 1992 update. JAMA 1992; 268: 2069-73.
17. Galal ME, Medhat ME, Khalid AS, Howaida GE. Rheumatic fever and rheumatic heart disease. In: The Science and practice of Pediatric Cardiology. Garson A, Bricker JT, Fisher DJ, Neish SR (eds). 2nd ed. Baltimore: Williams and Wilkins, 1998: 1691-24.
18. Fae KC, Oshiro SE, Toubert A, Charron D, Kalil J, Guilherme L. How an autoimmune reaction triggered by molecular mimicry between streptococcal M protein and cardiac tissue proteins leads to heart lesions in rheumatic heart disease. J Autoimmun 2005; 24: 101-9.
19. Akalın, Figen. "Novelties in acute rheumatic fever." Turkish Archives of Pediatrics 2007; 42.3: 85-93.
20. 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. Guidelines for the diagnosis of acute rheumatic fever. Jones criteria 1992 update. JAMA 1992; 268: 2069-73.
21. Ferreri P. Proceedings of the Jones criteria workshop. Circulation 2002; 106: 2521-3.
22. Narula J, Chandrasekhar Y, Rahimtoola S. Diagnosis of active rheumatic carditis. The echoes of change. Circulation 1999; 100: 1576-81.
23. Tubridy-Clark M, Carapetis JR. Subclinical carditis in rheumatic fever: a systematic review. Int J Cardiol 2007; 119:54-8.
24. Olgunturk R, Canter B, Tunao.lu FS, Kula S. Review of 609 patients with rheumatic fever in terms of revised and updated Jones criteria. Int J Cardiol 2006; 112: 91-8.
25. Turley AJ, McCarron B, de Belder MA. Acute rheumatic fever mimicking acute coronary syndrome. Emerg Med J 2006; 23: e45.
26. Gunal N, Baysal K, Hacıomeroğlu P, Belet N, Kolbak›r F. Rheumatic fever and coronary vasculitis in children. Acta Paediatr 2006; 95:118-20.
27. Unal N, Kosecik M, Saylam GS, K›r M, Paytoncu S, Kumtepe S. Cardiac tamponade in acute rheumatic fever. Int J Cardiol 2005; 103: 217-8.
28. Mohindra R, Pannu HS, Mohan B, et al. Syncope in a middle aged male due to acute rheumatic fever. Indian Heart J 2004; 56: 668-9.
29. Kula S, Olgunturk R, Ozdemir O. Two unusual presentations of acute rheumatic fever. Cardiol Young 2005; 15: 514-6.
30. Kula S, Saygılı A, Tunao.lu FS, Olgunturk R. Acute poststreptococcal glomerulonephritis and rheumatic fever in the same patient: a case report and review of the literature. Anadolu Kardiyol Derg 2003; 3: 272-4.
31. Ei-Menyar A, Ai-Hroob A, Numan MT, Gendi SM, Fawzy IM. Unilateral pulmonary edema: unusual presentation of acute rheumatic fever. Pediatr Cardiol 2005; 26: 700-2.

Year 2021, Volume: 9 Issue: 3, 120 - 125, 31.12.2021

Vildan Güngörer Ahmet Sert Şükrü Arslan

https://doi.org/10.21765/pprjournal.975657

Abstract

References

1. Tani LY. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll MD, Shaddy RE, Feltes TF, (eds). Moss and Adams’ Heart Disease in Infants, Children, and Adolescents. 8th ed. Philadelphia, PA: Lippincott Williams &Wilkins, 2013:1303-30.
2. Barash Y, Matityahu A. Acute rheumatic fever. Isr J Fam Pract 2005; 15:7–13.
3. Carapetis JR, Currie BJ, Mathews JD. Cumulative incidence of rheumatic fever in an endemic region: a guide to the susceptibility of the population? Epidemiol Infect 2000; 124:239– 244.
4. Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005; 366:155–168.
5. Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 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 1992; 268:2069– 2073.
6. World Health Organization. Strategy for controlling rheumatic fever/rheumatic heart disease, with emphasis on primary prevention: memorandum from a joint WHO/ISFC meeting. Bull World Health Organ 1995; 73:583–587
7. Carapetis JR, Brown A, MAguire G, Walsh W, Noonan S, Thompson D. The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2nd ed. Sydney: Heart Foundation and Cardiac Society of Australia and New Zealand, 2012.
8. Tani LY, Veasy G, Minich L, Shaddy RE. Rheumatic fever in children younger than 5 years: Is the presentation different? Pediatrics 2003; 112: 1065-8.
9. Wang C, Liu C, Li Y, Liu M. Adult onset acute rheumatic fever. Possible resurgence in southern Taiwan. J Clin Rheumatol 2005; 11: 146-9.
10. Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones criteria for the diagnosis of the rheumatic fever in the era of Doppler echocardiography: A scientific statement of the American Heart Association. Circulation 2015; 131:1806-18.
11. Tibazarwa K, Volmink J, Mayosi B. Incidence of acute rheumatic fever in the world: a systematic review of population-based studies. Heart 2008; 94:1534-40.
12. Köksal AO, Gültekin Soylu A, Özdemir O. Akut Romatizmal Ateş. Turkish J Pediatr Dis 2016; 4: 283-296.
13. Orün UA, Ceylan O, Bilici M, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012; 171: 361-8.
14. Madden S, Kelly L. Update on acute rheumatic fever; it stil exists in remote communities. Can Fam Physician 2009; 55:475-8.
15. Narin N, Mutlu F, Argun M, et al. Incidence and clinical features of acute rheumatic fever in Kayseri, Central Anatolia 1998-2011. Cardiol Young 2015; 25:745-51.
16. Dajani AS, Ayooub E, Bierman FZ, et al. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young the American Heart Association. Guidelines for the diagnosis of rheumatic fever. Jones criteria, 1992 update. JAMA 1992; 268: 2069-73.
17. Galal ME, Medhat ME, Khalid AS, Howaida GE. Rheumatic fever and rheumatic heart disease. In: The Science and practice of Pediatric Cardiology. Garson A, Bricker JT, Fisher DJ, Neish SR (eds). 2nd ed. Baltimore: Williams and Wilkins, 1998: 1691-24.
18. Fae KC, Oshiro SE, Toubert A, Charron D, Kalil J, Guilherme L. How an autoimmune reaction triggered by molecular mimicry between streptococcal M protein and cardiac tissue proteins leads to heart lesions in rheumatic heart disease. J Autoimmun 2005; 24: 101-9.
19. Akalın, Figen. "Novelties in acute rheumatic fever." Turkish Archives of Pediatrics 2007; 42.3: 85-93.
20. 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. Guidelines for the diagnosis of acute rheumatic fever. Jones criteria 1992 update. JAMA 1992; 268: 2069-73.
21. Ferreri P. Proceedings of the Jones criteria workshop. Circulation 2002; 106: 2521-3.
22. Narula J, Chandrasekhar Y, Rahimtoola S. Diagnosis of active rheumatic carditis. The echoes of change. Circulation 1999; 100: 1576-81.
23. Tubridy-Clark M, Carapetis JR. Subclinical carditis in rheumatic fever: a systematic review. Int J Cardiol 2007; 119:54-8.
24. Olgunturk R, Canter B, Tunao.lu FS, Kula S. Review of 609 patients with rheumatic fever in terms of revised and updated Jones criteria. Int J Cardiol 2006; 112: 91-8.
25. Turley AJ, McCarron B, de Belder MA. Acute rheumatic fever mimicking acute coronary syndrome. Emerg Med J 2006; 23: e45.
26. Gunal N, Baysal K, Hacıomeroğlu P, Belet N, Kolbak›r F. Rheumatic fever and coronary vasculitis in children. Acta Paediatr 2006; 95:118-20.
27. Unal N, Kosecik M, Saylam GS, K›r M, Paytoncu S, Kumtepe S. Cardiac tamponade in acute rheumatic fever. Int J Cardiol 2005; 103: 217-8.
28. Mohindra R, Pannu HS, Mohan B, et al. Syncope in a middle aged male due to acute rheumatic fever. Indian Heart J 2004; 56: 668-9.
29. Kula S, Olgunturk R, Ozdemir O. Two unusual presentations of acute rheumatic fever. Cardiol Young 2005; 15: 514-6.
30. Kula S, Saygılı A, Tunao.lu FS, Olgunturk R. Acute poststreptococcal glomerulonephritis and rheumatic fever in the same patient: a case report and review of the literature. Anadolu Kardiyol Derg 2003; 3: 272-4.
31. Ei-Menyar A, Ai-Hroob A, Numan MT, Gendi SM, Fawzy IM. Unilateral pulmonary edema: unusual presentation of acute rheumatic fever. Pediatr Cardiol 2005; 26: 700-2.

There are 31 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Articles
Authors	Vildan Güngörer Ahmet Sert Şükrü Arslan
Early Pub Date	September 15, 2021
Publication Date	December 31, 2021
Acceptance Date	August 12, 2021
Published in Issue	Year 2021 Volume: 9 Issue: 3

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Vancouver	Güngörer V, Sert A, Arslan Ş. Acute Rheumatic Fever Cases Presented with Enthesitis: A Different View on Acute Rheumatic Fever. pediatr pract res. 2021;9(3):120-5.

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