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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 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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Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
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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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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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Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as  SH2...
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Rheumatoid vasculitis: study of 41 cases.

Alejandro Olivé1, Anne Riveros1, Pablo Juárez2

  • 1Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), España.

Medicina Clinica
|March 10, 2020
PubMed
Summary

Rheumatoid vasculitis, a severe complication of rheumatoid arthritis, presents with cutaneous and neurological symptoms. While its frequency appears to be decreasing, the clinical severity remains consistent, necessitating continued vigilance and treatment strategies.

Keywords:
Artritis reumatoideRheumatoid arthritisRheumatoid vasculitisVasculitisVasculitis reumatoide

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Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Medicine

Background:

  • Rheumatoid vasculitis is a serious extra-articular manifestation of rheumatoid arthritis.
  • Understanding its clinical profile, treatment, and outcomes is crucial for patient management.

Observation:

  • A retrospective study analyzed 41 patients diagnosed with rheumatoid vasculitis between 1975 and 2017.
  • The majority of patients had erosive rheumatoid arthritis with positive rheumatoid factor and anti-citrullinated antibodies.
  • Common clinical manifestations included skin involvement (68%) and polyneuritis (63%).

Findings:

  • All patients received glucocorticoids, with 58.5% also treated with immunosuppressants and 12% with biologics.
  • Mortality after two years was 33%, primarily due to infection and vasculitis progression.
  • A decrease in the frequency of rheumatoid vasculitis was observed over the study period.

Implications:

  • Despite a potential decrease in incidence, rheumatoid vasculitis remains a severe condition with significant morbidity and mortality.
  • Treatment strategies involve glucocorticoids, often combined with immunosuppressants or biologics.
  • Further research may explore evolving treatment paradigms and risk factors for this rheumatoid arthritis complication.