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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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[Relapsing polychondritis presenting as encephalitis].

Satoshi Fujiwara1, Kiichiro Zenke, Shinji Iwata

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Summary

Relapsing polychondritis (RP) can rarely affect the central nervous system, causing encephalitis. Early diagnosis and steroid treatment are crucial for managing neurological complications in RP patients.

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Area of Science:

  • Neurology
  • Immunology
  • Rheumatology

Background:

  • Relapsing polychondritis (RP) is a rare autoimmune disorder affecting cartilaginous tissues.
  • Central nervous system involvement in RP is uncommon.

Observation:

  • A 60-year-old man with RP presented with headache and ear swelling, followed by acute neurological deficits including speech impediment, acalculia, agraphia, disorientation, and hemiparesis.
  • Brain imaging revealed inflammatory lesions in the left frontal lobe, initially suspected as meningoencephalitis.

Findings:

  • Brain biopsy confirmed chronic meningeal inflammation, leading to a diagnosis of RP-associated encephalitis.
  • Treatment with prednisone resulted in significant improvement of both neurological symptoms and MRI findings.

Implications:

  • This case highlights the importance of considering RP in patients with unexplained neurological symptoms.
  • Prompt diagnosis and immunosuppressive therapy, particularly corticosteroids, are vital for managing RP-induced central nervous system complications.