[Acute rheumatic polyarthritis in young men].

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Acute rheumatic fever (ARF) is an inflammatory condition following streptococcal infection.
• Joint involvement is a hallmark of ARF, but its specific patterns require detailed characterization.

Purpose of the Study:

• To investigate the spectrum of joint impairment in patients with acute rheumatic fever.
• To compare synovial fluid characteristics in ARF with those in reactive arthritis.

Main Methods:

• Examination of 200 patients diagnosed with acute rheumatic fever.
• Analysis of synovial fluid from 11 ARF patients for cytological, biochemical, and immunological markers.
• Comparison of findings with synovial fluid from patients with reactive arthritis.

Main Results:

• A high prevalence (96%) of joint impairment was observed in ARF patients, predominantly as migrating polyarthritis.
• The knee (80%) and talocrural (72%) joints were most frequently affected.
• Atypical presentations included monoarthritis (4%) and involvement of small joints (6%) and sternoclavicular articulations (3.5%).
• Synovial fluid analysis revealed no significant differences between ARF and reactive arthritis groups.

Conclusions:

• Acute rheumatic fever frequently manifests with polyarticular joint involvement, with specific joints being more susceptible.
• The synovial fluid profile in ARF is comparable to that of reactive arthritis, suggesting potential overlappingpathophysiological mechanisms.