Aggiornamento
La malattia reumatica nel 2016
Acute Rheumatic fever in 2016
Serena Pastore1, Federico Marchetti2, Andrea Taddio1, Maria Sole Conte1, Martina Tubaro1, Alessandro Ventura1
1Clinica Pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Università di Trieste
2UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
Settembre 2016 - pagg. 429 -436
Abstract
Acute Rheumatic Fever (ARF) continues to be a major health hazard in most developing
countries as well as sporadically in developed economies. Despite reservations about
the utility, Doppler echocardiographic studies have identified a massive burden of ARF
suggesting the inadequacy of the Jones’ criteria, which have recently been updated for
the first time since 1992 by including echocardiographic evidence of carditis and a wider
spectrum of joint manifestations as major criteria. Diagnosis of ARF is based on the
presence of documented preceding Group A Streptococcal (GAS) infection, in addition
to the presence of two major manifestations or one major and two minor manifestations
of the revised Jones criteria. Without documentation of antecedent GAS infection, the
diagnosis is much less likely except in a few rare scenarios. This issue focuses on the clinical
evaluation and treatment of patients with ARF by offering a thorough review of the
literature on diagnosis and recommendations about appropriate treatment.
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Bibliografia
Epidemiologia
• Breda L, Marzetti V, Gaspari S, Del Torto
M, Chiarelli F, Altobelli E. Population-based
study of incidence and clinical characteristics
of rheumatic fever in Abruzzo, central Italy
2000-2009. J Pediatr 2012;160:832-6.
• Di Mario S, Gagliotti C, Moro ML. Faringotonsillite
in età pediatrica. Linea guida regionale.
Bologna, maggio 2015. http://assr.
regione.emilia-romagna.it/it/servizi/pubblicazioni/
dossier/doss253.
• Essop MR, Peters F. Contemporary issues
in rheumatic fever and chronic rheumatic
heart disease. Circulation 2014;130(24):2181-8.
• Marijon E, Ou P, Celermajer DS, et al. Prevalence
of rheumatic heart disease detected
by echocardiographic screening. N Engl J
Med 2007;357(5):470-6.
• Pastore S, De Cunto A, Benettoni A, Berton
E, Taddio A, Lepore L. The resurgence of
rheumatic fever in a developed country area:
the role of echocardiography. Rheumatology
(Oxford) 2011;50:396-400.
• Rémond M, Atkinson D, White A, et al. Are
minor echocardiographic changes associated
with an increased risk of acute rheumatic fever
or progression to rheumatic heart disease?
Int J Cardiol 2015;198:117-22.
• Rothenbühler M, O’Sullivan CJ, Stortecky
S, et al Active surveillance for rheumatic
heart disease in endemic regions: a systematic
review and meta-analysis of prevalence
among children and adolescents. Lancet
Glob Health 2014;2(12):e717-26.
• Zühlke L, Engel ME, Lemmer CE, et al.
The natural history of latent rheumatic heart
disease in a 5 year follow-up study: a prospective
observational study. BMC Cardiovasc
Disord 2016;16:46.
Patogenesi
• Delunardo F, Scalzi V, Capozzi A, et al.
Streptococcal-vimentin cross-reactive antibodies
induce microvascular cardiac endothelial
proinflammatory phenotype in rheumatic
heart disease. Clin Exp Immunol 2013;173
(3):419-29.
• Martin WJ, Steer AC, Smeesters PR, et al.
Post-infectious group A streptococcal autoimmune
syndromes and the heart. Autoimmun
Rev 2015;14(8):710-25.
Diagnosi
• Reményi B, Wilson N, Steer A, et al. World
Heart Federation criteria for echocardiographic
diagnosis of rheumatic heart diseasean
evidence-based guideline. Nat Rev Cardiol
2012;9(5):297-309.
• Tani LY, Veasy LG, Minich LL, Shaddy RE.
Rheumatic fever in children younger than 5
years: is the presentation different? Pediatrics
2003;112:1065.
Articoli di revisione - Linee Guida
• Carapetis JR, McDonald M, Wilson NJ. Acute
rheumatic fever. Lancet 2005;366:155-68.
• Gewitz MH, Baltimore RS, Tani LY, et al;
American Heart Association Committee on
Rheumatic Fever, Endocarditis, and Kawasaki
Disease of the Council on Cardiovascular
Disease in the Young. Revision of the Jones
Criteria for the diagnosis of acute rheumatic
fever in the era of Doppler echocardiography:
a scientific statement from the American
Heart Association. Circulation 2015;
131(20):1806-18.
• Guidelines for the Diagnosis of Rheumatic
Fever. Jones Criteria, 1992 update. Special
Writing Group of the Committee on Rheumatic
Fever, Endocarditis, and Kawasaki Disease
of the Council on Cardiovascular Disease
in the Young of the American Heart Association.
JAMA 1992;268:2069-7.
• Markham R, Tulloh R. Fifteen-minute consultation:
rheumatic fever. Arch Dis Child
Educ Pract Ed 2015;100(4):176-9.
• Remenyi B, El Guindy A, Smith SC Jr, Yacoub
M, Holmes DR Jr. Valvular aspects of
rheumatic heart disease. Lancet 2016;387
(10025):1335-46.
• Webb RH, Grant C, Harnden A. Acute
rheumatic fever. BMJ 2015;351:h3443.
Trattamento e profilassi
della malattia reumatica
• Cilliers A, Adler AJ, Saloojee H. Anti-inflammatory
treatment for carditis in acute
rheumatic fever. Cochrane Database Syst
Rev 2015;(5):CD003176.
• Cilliers AM. Rheumatic fever and its management.
BMJ 2006;333:1153-6.
• Gerber MA, Baltimore RS, Eaton CB, et al.
Prevention of rheumatic fever and diagnosis
and treatment of acute Streptococcal pharyngitis:
a scientific statement from the American
Heart Association Rheumatic Fever, Endocarditis,
and Kawasaki Disease Committee
of the Council on Cardiovascular Disease in
the Young, the Interdisciplinary Council on
Functional Genomics and Translational Biology,
and the Interdisciplinary Council on
Quality of Care and Outcomes Research: endorsed
by the American Academy of Pediatrics.
Circulation 2009;119(11):1541-51.
• Hashkes PJ, Tauber T, Somekh E, et al.
Pediatric Rheumatology Study Group of
Israel. Naproxen as an alternative to aspirin
for the treatment of arthritis of rheumatic fever:
a randomized trial. J Pediatr 2003;143
(3):399-401.
• Manyemba J, Mayosi BM. Penicillin for secondary
prevention of rheumatic fever. Cochrane
Database Syst Rev 2002;(3):CD002227.
• Marijon E, Mirabel M, Celermajer DS, Jouven
X. Rheumatic heart disease. Lancet 2012;
379:953-64.
• Paz JA, Silva CA, Marques-Dias MJ. Randomized
double-blind study with prednisone in
Sydenham’s chorea. Pediatr Neurol 2006;34
(4):264-9.
• Walker AR, Tani LY, Thompson JA, et al.
Rheumatic chorea: relationship to systemic
manifestations and response to corticosteroids.
J Pediatr 2007;151(6):679-83.
• Wilson N. Secondary prophylaxis for rheumatic
fever: simple concepts, difficult delivery.
World J Pediatr Congenit Heart Surg
2013;4(4):380-4.
• World Health Organization. Rheumatic fever
and rheumatic heart disease: report of
WHO expert consultation. WHO, 2004:923.
Corrispondenza: serena.pastore82@gmail.com
