Rheumatic Fever: An Autoimmune Disease

If a streptococcal infection such as pharyngitis or scarlet fever is left untreated, there is a small (~3%) chance that within approximately 20 days, the patient will present with rheumatic fever. After the first bout of rheumatic fever, if the host acquires a second untreated S. Pyogenes infection, the chance of coming down with rheumatic fever jumps substantially to ~50%. Most often this secondary disease will strike people aged 6-15 years old, roughly 20 days after the streptococcal infection, with a 2-5% mortality rate. One of the major diagnostic symptoms of this disease is Erythema Marginatum, snake- or ring-like eruptions covering the trunk, upper arms, and legs. Other symptoms include fever, arthritis (elbows, knees, wrists, and ankles), swollen joints, pain in the abdomen, nodules

A 32-year old nurse who has rheumatic fever as a child noticed a persistent tachycardia and light-headedness. Upon examination, chest x rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation. There was also mild pulmonary congestion. Cardiac evaluation resulted in the following information:

Rheumatic heart disease is a complication of rheumatic fever in which the heart valves are damaged. Rheumatic fever is an inflammatory disease that begins with strep throat. It can affect connective tissue throughout the body, especially in the heart, joints, brain and skin. Although rheumatic fever can strike people of all ages, it is most common in children between 5 and 15 years old. The best way to prevent rheumatic fever is to treat strep

Rheumatic heart disease- is as a result of a bacterial infection as a child, resulting in pain in the chest and joints, also affecting heart valve functionality.

First, it is very difficult to diagnose rheumatoid arthritis in its early stages. It is difficult to diagnose because its symptoms are very similar to many other diseases. Second, the treatment has no one cure. This means there are things you can do to help, but there is not one thing that cures it. Next, the environmental factors are very few. One of which is infection with certain bacteria and viruses may trigger the disease. The other reason is smoking tobacco. The testing and diagnosis, treatment, and environmental factors are very dreadful

It’s an autoimmune disease that causes inflammation of the lining of the joints. An autoimmune disease occurs when the individuals own immune system fails to recognize healthy tissue. The immune system, designed to protect our health by attacking foreign cells such as viruses, instead attacks the body’s healthy tissue. As a result, fluid builds up in the joints causing inflammation and joint pain. According to WebMD, Rheumatoid Arthritis is a type of arthritis that occurs in joints on both sides of the body. This symmetry helps distinguish Rheumatoid Arthritis from other types of arthritis. The Centers for Disease Control and Prevention says “the inflamed synovium leads to erosions of the cartilage and bone.” This inflammatory process primarily affects the lining of the joints, known as the synovial membrane, but can also affect other organs. As stated by James Warson, “the causes of Rheumatoid Arthritis are not known, but several theories are under investigation” (63). Some theories suggest that a virus may alter the immune system, causing it to attack the joints. Other theories suggest that exposure to smoking may lead to Rheumatoid Arthritis. It’s believed to be due to a combination of genetic, environmental, and hormonal

Rheumatic Fever is an inflammatory disease, caused by strep A when it is not cured correctly. About five percent of patients that have not been treated for strep A develop Rheumatic Fever. The immune system of a person with this disease is attacking bacteria, but also good tissue, usually on the heart. Children ages six to sixteen are most likely to get this. There is a high chance of dying from the disease if not cured correctly. Some symptoms may include; inflamed joints, fever, weakness, chest pain, rashes, chorea (abnormal movements/jolts) plus more. The diagnosis of Rheumatic fever involves a series of examinations by multiple doctors, looking closely at the symptoms of the patient and doing things such as chest x rays and heart monitors.

The reason this is the answer is because acute rheumatic fever is a complication that can occur post strep. In order to be diagnosed with rheumatic fever, a person must have a history of strep infection, plus at least one of the major and 2 minor or two majors. The criteria is known as the Jones criteria. The major symptoms are carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. The minor criteria include a fever, arthralgia, previous history of disease, acute phase reactions, and prolonged QT interval.

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatologic disease in children and is one of the most common chronic diseases of childhood. The onset is either insidious or abrupt, and common symptoms include morning stiffness, gelling phenomenon, daytime arthralgias, and difficulty in the use of the patients’ joints. Spiking fevers occurring once or twice each day at about the same time of day, evanescent rash on the trunk and extremities, and psoriasis are other findings seen in JIA.

The pathogenesis of RA remains somewhat unclear, which also contributes to the underlying cause that initiates the process. However, strong clinical researches associated RA to occurrence of inflammation, and on the role of autoantibodies and immune complexes in initiation of the pathogenic process (73).

Rheumatic fever is an autoimmune response that develops from group A Streptococcal infection (GAS) (Webb & Wilson, 2013). When left undiagnosed, this can led to rheumatic heart disease (RHD), which continues to cause over 200 deaths yearly in New Zealand (Gilbert, Wilson & Finucane, 2011). This disease affects Māori at a significantly higher rate than any other ethnicity in New Zealand (Wilson, 2010). Rheumatic fever is an important topic because it is vital to address the concerning cases in New Zealand, and it is also important that this disease is prevented (Lennon, Stewart, Farrell, Palmer & Mason, 2009). This assignment will focus on two main themes from the literature. Theme one will be focusing on how the current health inequalities are been put in place for Māori, and theme two will be focusing on how effective are the current educational awareness being implicated in New Zealand.

In the case of Martha, she had an episode of rheumatic fever in her twenties. Rheumatic fever, of which is an illness brought on by Streptococcus A, produces a protein that attaches to the cell wall of an organism causing inflammation. This can affect the heart and cause pancarditis, which is an infection of the entire heart. Endocarditis is the portion of pancarditis that causes valvular disorders. Though the pulmonic valve is not commonly affected, it is still a possibility. The valve apparatus can become fused leading to stenosis years after a rheumatic fever episode that is acute, and damage can become progressive if there are subsequent episodes (Chin, 2014). With Martha 's murmur being low in pitch and more of a rumbling, it is considered a narrowing of the valve or stenosis. The murmur is located left of the sternal border and in the upper portion. This is the pulmonic valve region, which would make this a pulmonic valve stenosis (Rao, 2014). According to Rao (2014), the murmur is due to the leaflets of the pulmonic valve not completely opening. This causes a resistance of the blood flowing foward through the valve, which happens during systole of the ventricles. This further causes a turbulence of the blood and makes the sound of the murmur. Pulmonic valve stenosis can then lead to ventricular hypertrophy of the right ventricle, which is proportional to how obstructed the valve becomes (Rao, 2014).

Acute Rheumatic Fever (ARF) is a preventable and controllable chronic heart condition that is a consequence of pharyngeal infection by Group A streptococcus. The infection causes flu like symptoms but if left untreated has the ability to cause fibrosis of the heart valves, which can lead to heart disease, heart failure and eventually death; this progression of the disease is redefined as Rheumatic Heart Disease (RHD). ARF is easily treatable, achieved by a 10 day course of antibiotics or an injection (World Heart Federation, 2015).

Group A streptococcus (GAS) is an important human pathogen rank in the top ten of deadly infectious disease around the world despite being sensitive to most antibiotics that are used clinically. The major population will have suffered a group A streptococcus infection one time or another with non-life threating minor complications in the presence of antibiotic therapy but in some instances it goes on and causes several immune-mediated disorders associated with rheumatic fever affecting a diverse set of organs and tissues including the heart, kidneys, skin, joints, and brain. The propensity and degree to which Group A Streptococcus produces an invasive systemic infection is interrelated to its diverse virulence factor expression,

A short online survey was sent to 240 corresponding authors, but 17 were excluded from the analyses. Specifically, one corresponding author was on annual leave; 2 rejected the invitation emails, and 14 authors provided a wrong email address. Thus, the main reason for exclusion (5.8%) was the inability to reach the selected population. Half of the incorrect email addresses (n=7) were from corresponding authors who published a peer-reviewed RCT article in a respiratory journal, the second half (n=7) in rheumatology journals (Table 1). In details, 4 out of 7 corresponding authors published a paper in the European Respiratory Journal and 3 out of 7 in Annuals of Rheumatic Diseases.