Clinical Rheumatology

, Volume 33, Issue 7, pp 893–901 | Cite as

Acute rheumatic fever and streptococci: the quintessential pathogenic trigger of autoimmunity

  • Soumya D. Chakravarty
  • John B. Zabriskie
  • Allan Gibofsky
Review Article


Acute rheumatic fever (ARF) is a non-suppurative complication of pharyngeal infection with group A streptococcus. Signs and symptoms of ARF develop 2 to 3 weeks following pharyngitis and include arthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum. In developing areas of the world, ARF and rheumatic heart disease are estimated to affect nearly 20 million people and remain leading causes of cardiovascular death during the first five decades of life. ARF still represents one of the quintessential examples of a pathogenic trigger culminating in autoimmune manifestations. In this review, we will focus on the pathogenesis and etiology of ARF and its complications, along with diagnostic and treatment approaches to both ameliorate and prevent long-term sequelae of this potentially debilitating disease.


Autoimmunity Group A streptococcus Inflammation Microbiome Molecular mimicry Rheumatic heart disease 


Conflict of interest

There are no relevant conflicts to disclose by any of the authors.


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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Soumya D. Chakravarty
    • 1
  • John B. Zabriskie
    • 2
  • Allan Gibofsky
    • 1
  1. 1.Division of Rheumatology, Hospital for Special Surgery and Department of MedicineNew York Presbyterian Hospital—Weill Cornell Medical CenterNew YorkUSA
  2. 2.Laboratory of Clinical Microbiology and ImmunologyRockefeller UniversityNew YorkUSA

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