Volume 14 Supplement 1

Proceedings of the 8th Global Arthritis Research Network (GARN) Meeting and 1st Bio-Rheumatology International Congress (BRIC)

Open Access

Features of rheumatic fever in adult patients in modern Kyrgyzstan

  • Nazgul A Omurzakova1,
  • Aynagul S Djumagulova1,
  • Raisa I Rudenko1,
  • Kusuki Nishioka2 and
  • Toshihiro Nakajima2
Arthritis Research & Therapy201214(Suppl 1):P57

DOI: 10.1186/ar3692

Published: 29 February 2012

Objective

Study of peculiarities of rheumatic fever (RF) in adult patients.

Materials and methods

We have studied prospectively for 5 years 200 patients (56 men and 144 women) with acute rheumatic fever (ARF in 27) and recurrent ARF (in 173) at the age of 15-40 years (average age ± 24,5 7 years). Clinical and laboratory (ESR, antistreptolysin-O (ASL-O) and CRP) and instrumental (ECG, ECG monitoring daily, 2-D echocardiography color) studies conducted. The diagnosis of ARF was verified according to the WHO diagnostic criteria in the modification of Jones' criteria, AHA (1999) and WHF (2008).

Results: We found that predisposing factors for the development of ARF was the presence of tonzillopharingitis (47.5%), while carriers of group A streptococcus (GAS) was 38.0% among patients examined. Clinical symptoms of carditis with echocardiographic signs of valvulitis occurred in 196 (98.0%) patients. In 54 (27.5%) of them installed valvulitis mitral valve. Valvulitis aortic valve was detected in 24 (12.2%) patients. In 118 (60.2%) patients observed at the same time valvulitis mitral and aortic valves, while in 22 (39.2%) patients are men and 92 (63.8%) patients are women. In 18 (66.6%) patients with ARF was observed mitral valve prolapse (MVP), in 6 (22.2%) were in men, 12 (44.4%) in women. In 9 (4.5%) patients with ARF proceeded pancarditis (endocarditis, myocarditis and pericarditis). Signs of coronaritis with typical anginal pain with ECG signs of ischemia, arrhythmias, heart block were observed in 12 (6.0%) patients with RF. Verification of diagnosis was carried out using the angiography of coronary arteries. The symptoms of coronaritis in this patients disappeared after anti-inflammatory therapy. Polyarthritis with ARF was observed in 40.7% of patients, 25 (14.4%) of patients with recurrent ARF articular syndrome manifested primarily arthralgia. In addition, 6.5% in patients with RF were observed asymptomatic sacroiliitis stage I-II (Dale), 7 of patients are men and 5 of them are women.

Conclusion

The reducing of clinical manifestations of ARF in adult led to gypo-diagnostics of disease, a consequence of which was the formation of rheumatic heart disease.

Authors’ Affiliations

(1)
National Center of Cardiology and Internal Medicine
(2)
Institute of Medical Science, Tokyo Medical University

Copyright

© Omurzakova et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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