Changes of manifestations of 122 patients with rheumatic fever in South China during last decade

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• 作者：Lin Chen (1)
  Xujing Xie (1)
  Jieruo Gu (2)
  Li Xu (1)
  Xubing Yang (1)
  Buyun Yu (2)
  
• 关键词：Rheumatic fever ; Carditis ; Diagnosis ; Streptococcus
• 刊名：Rheumatology International
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：30
• 期：2
• 页码：239-243
• 全文大小：211KB
• 参考文献：1. Huang ZD, Rao XX, Cen RC et al (1998) An updated epidemiologic survey of acute rheumatic fever among school-age children in China. Chin J Cardiol 26:94-7
  2. Wang ZM, Zou YB, Song L et al (2006) Prevalence of chronic rheumatic heart disease in Chinese adults. Int J Cardiol 107:356-59. doi:10.1016/j.ijcard.2005.03.048 CrossRef
  3. Pereira BA, da Silva NA, Andrade LE, Lima FS, Gurian FC, de Almeida Netto JC (2007) Jones criteria and underdiagnosis of rheumatic fever. Indian J Pediatr 74:117-21. doi:10.1007/s12098-007-0001-6 CrossRef
  4. Khriesat I, Najada AH (2003) Acute rheumatic fever without early carditis: an atypical clinical presentation. Eur J Pediatr 162:868-71. doi:10.1007/s00431-003-1320-x CrossRef
  5. Huang JL, Yu BY, Wu YQ, Chen GQ (2000) Clinical characteristics of acute rheumatic fever in 1990- Chin J Rheumatol 4:284-86 (in Chinese)
  6. World Health Organization (2004) Rheumatic fever and rheumatic heart disease. Report of a WHO expert consultation. World Health Organization, Geneva (Technical Report Series No. 923)
  7. Carapetis JR, Currie BJ (2001) Rheumatic fever in a high incidence population the importance of monoarthritis and low grade fever. Arch Dis Child 85:223-27. doi:10.1136/adc.85.3.223 CrossRef
  8. Rana O, Berna C, Fatma ST, Serdar K (2006) Review of 609 patients with rheumatic fever in terms of revised and updated Jones criteria. Int J Cardiol 112:91-8. doi:10.1016/j.ijcard.2005.11.007 CrossRef
  9. Yu BY, Zhang HW, Gu JR, Zhang SG (2000) Group A streptococcal membrane used as a specific antigen of diagnosis of rheumatic carditis. Chin J Rheumatol 4:206-08 (in Chinese)
  10. Goldstein I, Halpern B, Robert L (1967) Immunological relationship between streptococcus A polysaccharide and the structural glycoproteins of heart valve. Nature 213:44-7. doi:10.1038/213044a0 CrossRef
  11. Peng CQ, Yu BY, Chen GQ, Liang H (1998) Specific significance of antibody to streptococcal polysaccharide in rheumatic valvulitis. Acad J SUMS 19:190-92 (in Chinese)
  12. Yu BY, Wu Z (2006) The application of serum antibody to group A streptococcal polysaccharide in the diagnosis of atypical rheumatic fever. Chin J Rheumatol 10:11-3 (in Chinese)
  13. Shulman ST, Ayoub EM, Victorica BE (1974) Differences in antibody response to streptococcal antigens in children with rheumatic and non-rheumatic mitral valve disease. Circulation 50:1244-251
  14. Ayoub EM, Nelson B, Shulman ST et al (2003) Group A Streptococcal antibodies in subjects with or without rheumatic fever in areas with high or low incidences of rheumatic fever. Clin Diagn Lab Immunol 10:886-90. doi:10.1128/CDLI.10.5.886-890.2003
  
• 作者单位：Lin Chen (1)
  Xujing Xie (1)
  Jieruo Gu (2)
  Li Xu (1)
  Xubing Yang (1)
  Buyun Yu (2)
  
  1. Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
  2. Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, 510630, Guangzhou, People’s Republic of China
  

文摘

The main objective of this study is to investigate changes of features of rheumatic fever (RF) in recent 10?years. A total of 315 patients with RF during 1985-995 (group 1) and 1997-007(group 2) were selected. Their manifestations were compared. Results show that the female/male ratio was 2.0. Group 2 had higher rate of low-grade fever and carditis, and lower rate of heart failure, lower positive rate of C-reactive protein and antistreptolycin o than group 1. In group 2, 61.4% patients fulfilled the updated Jones criteria, however, 76.2% fulfilled 2002-003 WHO criteria. Diagnosing rheumatic carditis, sensibility and specificity of lymphocyte procoagulant activity (PCA) were 79.1 and 71.4%, respectively, and those of antibody to streptococcal polysaccharide (ASP) were 70.3 and 70%, respectively. Follow-up data of 35 cases were available. Recurrent rate of RF was 62.8%. Only 1/3 cases received regular secondary prevention. In conclusion, mild carditis was increasing. PCA and ASP were valuable tests for diagnosing rheumatic carditis. Atypical cases and secondary prevention need more attention.