Advertisement

Rheumatology International

, Volume 29, Issue 9, pp 1041–1045 | Cite as

Acute rheumatic fever in adults: case report together with an analysis of 25 patients with acute rheumatic fever

  • Nuntana Kasitanon
  • Waraporn Sukitawut
  • Worawit Louthrenoo
Original Article

Abstract

We reported the oldest acute rheumatic fever (ARF) patient with initial attack at the age of 90 years and experience with ARF in adults in 20 years of observation. The case files of all ARF patients treated by rheumatology unit, Chiang Mai University, were reviewed. Demographic data and clinical profile were recorded and compared between patients with initial attack and patients with recurrent attack. A total of 25 patients with ARF were included. There was no different incidence of arthritis and carditis between two groups. Initial attack patients have higher incidence of prolonged PR-interval (67 vs. 12%, P = 0.049) and longer duration of admission to diagnosis (5 vs. 2 days, P = 0.05). Thirty percent presented initial attack after 30 years of age. ARF is more common in adults than previously recognized. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patients with arthritis.

Keywords

Acute rheumatic fever Adults Arthritis Carditis 

References

  1. 1.
    Feuer J, Spiera H (1997) Acute rheumatic fever in adults: a resurgence in the Hasidic Jewish community. J Rheumatol 24:337–340PubMedGoogle Scholar
  2. 2.
    Ravisha MS, Tullu MS, Kamat JR (2003) Rheumatic fever and rheumatic heart disease: clinical profile of 550 cases in India. Arch Med Res 34:382–387. doi: 10.1016/S0188-4409(03)00072-9 PubMedCrossRefGoogle Scholar
  3. 3.
    Carapetis JR, Currie BJ (2001) Rheumatic fever in a high incidence population: the importance of monoarthritis and low grade fever. Arch Dis Child 85:223–227. doi: 10.1136/adc.85.3.223 PubMedCrossRefGoogle Scholar
  4. 4.
    Carapetis JR, Currie BJ, Mathews JD (2000) Cumulative incidence of rheumatic fever in an endemic region: a guide to the susceptibility of the population? Epidemiol Infect 124:239–244. doi: 10.1017/S0950268800003514 PubMedCrossRefGoogle Scholar
  5. 5.
    Hanna JN, Heazlewood RJ (2005) The epidemiology of acute rheumatic fever in Indigenous people in north Queensland. Aust N Z J Public Health 29:313–317. doi: 10.1111/j.1467-842X.2005.tb00199.x PubMedCrossRefGoogle Scholar
  6. 6.
    Dajani AS, Ayoub E, Bierman FZ et al (1993) Guidelines for the diagnosis of rheumatic fever: Jones criteria, updated 1992. Circulation 87:302–307Google Scholar
  7. 7.
    Tani LY, Veasy LG, Minich LL, Shaddy RE (2003) Rheumatic fever in children younger than 5 years: is the presentation different? Pediatrics 112:1065–1068. doi: 10.1542/peds.112.5.1065 PubMedCrossRefGoogle Scholar
  8. 8.
    Zaman MM, Rouf MA, Haque S et al (1998) Does rheumatic fever occur usually between the ages of 5 and 15 years? Int J Cardiol 66:17–21. doi: 10.1016/S0167-5273(98)00140-5 PubMedCrossRefGoogle Scholar
  9. 9.
    Carapetis JR, Currie B, Good M (1996) Towards understanding the pathogenesis of rheumatic fever. Scand J Rheumatol 25:127–131. doi: 10.3109/03009749609080000 PubMedCrossRefGoogle Scholar
  10. 10.
    Wang CR, Liu CC, Li YH, Liu MF (2005) Adult-onset acute rheumatic fever: possible resurgence in southern Taiwan. J Clin Rheumatol 11:146–149. doi: 10.1097/01.rhu.0000164821.73024.86 PubMedCrossRefGoogle Scholar
  11. 11.
    Ben-Dov I, Berry E (1980) Acute rheumatic fever in adults over the age of 45 years: an analysis of 23 patients together with a review of the literature. Semin Arthritis Rheum 10:100–110. doi: 10.1016/0049-0172(80)90003-7 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Nuntana Kasitanon
    • 1
  • Waraporn Sukitawut
    • 1
  • Worawit Louthrenoo
    • 1
  1. 1.Division of Rheumatology, Department of Medicine, Faculty of MedicineChiang Mai UniversityChiang MaiThailand

Personalised recommendations