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Acute rheumatic fever and its consequences: a persistent threat to developing nations in the 21st century

Jennifer L Lee1, Stanley M Naguwa, Gurtej S Cheema

  • 1Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Suite 6510, Davis, CA 95616, USA.

Autoimmunity Reviews
|April 24, 2009
PubMed

Insights

Acute rheumatic fever (ARF) is an autoimmune disease following strep throat, primarily affecting children in developing nations. Rheumatic heart disease (RHD) is a major complication, but GAS vaccines may offer future prevention.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Pediatrics

Background:

  • Acute rheumatic fever (ARF) is an autoimmune sequela of group A Streptococcus (GAS) pharyngitis.
  • It disproportionately affects pediatric populations in developing countries.

Observation:

  • The primary cause of morbidity and mortality is rheumatic heart disease (RHD).
  • Cardinal symptoms include polyarthritis, Sydenham's chorea, subcutaneous nodules, and erythema marginatum.

Findings:

  • Current therapy targets GAS infection, acute symptoms with anti-inflammatories, and RHD with surgery.
  • Long-term antibiotic prophylaxis is essential for secondary prevention due to high recurrence rates.

Implications:

  • GAS vaccination is a promising future strategy for primary and secondary prevention of ARF and RHD.
  • Vaccination could significantly reduce the burden of ARF and RHD in vulnerable populations.

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