(4.) Ocal B, Karademir S, Oguz D, Oner A, Senocak F Acute rheumatic
carditis in HenochSchonlein purpura.
The efficacy of echocardiographic criterions for the diagnosis of
carditis in acute rheumatic fever.
The biopsy diagnosis of gastroesophageal reflux disease, "
carditis" and Barrett's esophagus, and sequelae of therapy.
MAJOR CRITERIA:
Carditis, polyarthritis, chorea, erythema marginatum and subcutaneous nodules.
A diagnosis of ARF was made on the basis of
carditis, arthralgia, high erythrocyte count, sedimentation rate, high ASO and a history of upper respiratory tract infection A temporary pacemaker was implanted on the day of admittance.
Of those for whom data were available in their inpatient records, one of 24 case-patients and one of 21 controls had a documented history of physician-observed erythema migrans (EM), and four of 24 case-patients and two of 21 controls had documented objective evidence of disseminated LD (i.e., secondary EM, arthritis,
carditis, meningitis, neuritis, encephalomyelitis, or encephalopathy) (2,3).
Major Manifestations:
Carditis, polyarthritis, chorea, erythema marginatum and subcutaneous nodules.
A new murmur of aortic or mitral regurgitation was considered as clinical evidence of
carditis. This was confirmed by echocardiographic guidelines to define pathological mitral and aortic insufficiency (18).
If arthritis is taken as major criteria, Arthralgia should not be taken as minor criteria and if
carditis is taken as major criterion, prolonged P-R interval should not be taken as minor criterion.
The patients who had polyarthritis (17/21) received acetylsalicylic acid 90 mg/kg/day and the patients who had
carditis (15/21) received prednisolone 2 mg/kg/day for 3-6 weeks until their acute phase levels returned to normal levels.
The diagnosis of Rheumatic fever can be made without satisfying 2 major/2 minor + 1 major criteria and obtaining evidence of Streptococcal infection in cases of (1) Chorea, if other causes are excluded (2) insidious/late onset
carditis with no other explanation.
Such reactions were mainly attributed to serum sickness and the tetanus antitoxin and were characterized as serum reactions, i.e., reactions complicated by acute
carditis (3), morphologic cardiac reactions, and lesions with rheumatic
carditis characteristics (4).