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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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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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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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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 IV: Nursing Management01:20

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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T Cell Types and Functions01:24

T Cell Types and Functions

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When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
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Lymphoid Cells and Tissues01:18

Lymphoid Cells and Tissues

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Lymphoid cells and tissues are integral to the immune system, which is crucial in maintaining our body's defense against harmful pathogens. They form the building blocks of lymphoid organs, which include the spleen, thymus, and lymph nodes.
Lymphoid cells consist of various types of immune system cells. These include B and T lymphocytes, which are responsible for producing antibodies and killing infected cells, respectively. Dendritic cells act as messengers between the innate and adaptive...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Updated: Apr 7, 2026

Anti-Nuclear Antibody Screening Using HEp-2 Cells
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Rheumatoid Nodules.

Jeremy S Tilstra1, Douglas W Lienesch1

  • 1Department of Rheumatology, UPMC, University of Pittsburgh, S700 Biomedical Center, 3500 Terrace Street, Pittsburgh, PA 15261, USA.

Dermatologic Clinics
|July 6, 2015
PubMed
Summary

Rheumatoid nodules, common in rheumatoid arthritis, are usually identifiable by appearance and location. Systemic therapies do not treat them, and some treatments may worsen them.

Keywords:
Accelerated nodulosisBenign nodulosisMethotrexatePalisading macrophagesPulmonary rheumatoid nodulesRheumatoid arthritisRheumatoid nodules

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Area of Science:

  • Rheumatology
  • Dermatopathology

Background:

  • Rheumatoid nodules are a frequent clinical finding in rheumatoid arthritis.
  • These lesions possess distinct diagnostic features and typical anatomical sites.
  • Histopathological examination of biopsied nodules reveals characteristic microscopic patterns.

Purpose of the Study:

  • To review current data on rheumatoid nodules.
  • To discuss associations and clinical management of rheumatoid nodules.

Main Methods:

  • Literature review of existing data on rheumatoid nodules.
  • Analysis of diagnostic criteria and treatment outcomes.

Main Results:

  • Rheumatoid nodules are typically diagnosed based on clinical and histological findings.
  • Systemic therapies for rheumatoid arthritis lack efficacy in treating rheumatoid nodules.
  • Certain treatments, such as methotrexate and TNF inhibitors, may paradoxically promote nodule formation.
  • Systemic involvement of rheumatoid nodules is uncommon.
  • Treatment is generally not indicated unless symptomatic or functionally impairing.

Conclusions:

  • Rheumatoid nodules are a well-defined manifestation of rheumatoid arthritis.
  • Current systemic treatments do not resolve rheumatoid nodules and may exacerbate their development.
  • Intervention for rheumatoid nodules is typically reserved for cases causing pain or functional disability.