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Rheumatic Heart Disease I: Introduction01:23

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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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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 (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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An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
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Elderly-onset rheumatoid arthritis vs. polymyalgia rheumatica: Differences in pathogenesis.

Jinzhi Wu1, Fan Yang1, Xinlei Ma1

  • 1Division of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Frontiers in Medicine
|January 30, 2023
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Summary

Elderly-onset rheumatoid arthritis and polymyalgia rheumatica share symptoms like morning stiffness and joint pain, making diagnosis difficult. This study clarifies their distinct pathogenesis to aid in early intervention and accurate differential diagnosis.

Keywords:
elderly-onset rheumatoid arthritisinflammationpathogenesispolymyalgia rheumaticarheumatoid arthritis

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Area of Science:

  • Rheumatology
  • Immunology
  • Geriatrics

Background:

  • Rheumatoid arthritis is a chronic autoimmune disease primarily affecting joints.
  • Elderly-onset rheumatoid arthritis (EORA) presents with symptoms overlapping polymyalgia rheumatica (PMR), including morning stiffness and shoulder/hip pain.
  • Distinguishing EORA from PMR in the elderly can be clinically challenging.

Purpose of the Study:

  • To elucidate the differing pathogenesis between EORA and PMR.
  • To provide a basis for clear differential diagnosis.
  • To facilitate effective early intervention strategies for elderly patients.

Main Methods:

  • Comparative analysis of clinical presentations.
  • Review of immunological markers and inflammatory pathways.
  • Pathogenesis differentiation based on disease characteristics.

Main Results:

  • EORA and PMR exhibit distinct underlying pathological mechanisms despite overlapping symptoms.
  • Key differences identified in inflammatory profiles and joint involvement patterns.
  • Understanding these distinctions is crucial for accurate diagnosis.

Conclusions:

  • Differentiating EORA and PMR requires careful consideration of their unique pathogenetic pathways.
  • Accurate differential diagnosis is essential for timely and appropriate treatment.
  • Further research into specific biomarkers may improve diagnostic certainty.