preview

Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD)

Better Essays

Acute rheumatic fever (ARF) is defined by Mosby (2010) as a systemic inflammatory disease which is enabled development with inadequate treatment of upper respiratory tract infections of group A beta-hemolytic streptococci. Repeated episodes of ARF can cause autoimmune reactions within the heart which in turn inflicts damage upon the heart muscle and heart valves, a condition termed as rheumatic heart disease (RHD) (Mosby, 2010). Predominately ARF and RDH cases are found to effect people living in developing countries. Steer and Carapetis (2009), have linked this issue with the lowered socioeconomic conditions, household crowding, inadequate health care and poor hygiene. In comparison both ARF and RHD have virtually been eliminated in …show more content…

Although the pathogenic mechanism of ARF and RHD is not yet fully understood, a correlation between rheumatogenic GAS strains and inheritably liable hosts, results in abnormal immune responses and the development of autoimmunity (Steer & Carapetis, 2009). This is caused by antibody cross-reactivity and more specifically a result of molecular mimicry (Porth & Matfin, 2009). In the usual situation of a streptococcus infection, an immune response will be instigated involving B cell presentation of the antigen, CD4- T cell differentiation, helper T cell formation and plasma B cell antibody production. Through this process the antibodies are enabled to destruct the precise protein structure of the GAS cell wall. However in this case, the targeted protein of the bacterium has considerable similarity to antigens presented on the heart and kidney tissues which causes autoimmune activity. Once the micro organisms have been eradicated, the remaining antibodies mistake the identity of certain somatic cell resulting in inflammation and the onset of ARF symptoms two to three weeks after the absence of the infection (Porth & Matfin, 2009).

Typical presentations of rheumatic fever (RF) include a history of sore throats, head aches, fever, abdominal pain, nausea and vomiting, swollen glands and other common signs and symptoms of streptococcal infection (Porth & Matfin, 2009). The presentation of RF can be acute, recurrent or chronic. The acute stage

Get Access