Chronic rheumatic heart disease with recrudescence of acute rheumatic fever on histology: a case report.

Autor:	Mutithu DW; Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur, J46, Old Main Building, Main Road, Observatory, Cape Town 7925, South Africa., Roberts R; Division of Anatomical Pathology, National Health Laboratory Service and University of Cape Town, Cape Town 7925, South Africa., Manganyi R; Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town 7925, South Africa., Ntusi NAB; Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur, J46, Old Main Building, Main Road, Observatory, Cape Town 7925, South Africa.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2022 Jul 05; Vol. 6 (7), pp. ytac278. Date of Electronic Publication: 2022 Jul 05 (Print Publication: 2022).
DOI:	10.1093/ehjcr/ytac278
Abstrakt:	Background: Rheumatic heart disease (RHD) is endemic in sub-Saharan Africa where it is the leading cause of cardiovascular mortality in the young. Rheumatic heart disease results from recurrent episodes of acute rheumatic fever (ARF), which are often difficult to diagnose clinically. Acute rheumatic fever may be diagnosed based on the revised Jones Criteria 2015 for the diagnosis of ARF. Histologically, acute rheumatic valvulitis manifests with active inflammation characterized by lymphocytic infiltration, Aschoff bodies, and Anitschkow cells. Chronic rheumatic valvulitis is associated with neovascularization, and/or dystrophic calcification. The combination of histological features of both ARF and chronic RHD is a rare finding. Case Summary: Here we report on a case of a 59-year-old woman with mixed aortic and mitral valve disease of probable rheumatic aetiology (elevated C-reactive protein and prolonged PR interval) and with histological evidence of lymphocytic infiltration, Aschoff bodies, and fibrinoid necrosis admixed with features of chronic RHD. Discussion: Cases of chronic RHD admixed with ARF are very rare; however, they should be considered in regions with a high prevalence of RHDs. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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