Percorsi clinici
Corea, artrite, eritema marginato: malattia reumatica e diagnosi differenziali
Chorea, arthritis, erythema marginatum: rheumatic disease and differential diagnosis
Antonino Maria Quintilio Alberio1, Filippo Pieroni1, Giulia Bini1, Alice Bonuccelli2, Alessandro Orsini2, Diego Peroni3, Rita Consolini4
1Scuola di Specializzazione in Pediatria, 2Sezione di Neurologia Pediatrica, 3Sezione di Pediatria, 4Sezione di Immunologia Clinica e di Laboratorio, UO di Pediatria, AOUP, Università di Pisa
Dicembre 2020 - pagg. 643 -650 | DOI: 10.53126/MEB39643
Abstract
The revision of the Jones criteria by the American Heart Association allowed the identification and diagnosis of a greater number of cases of Rheumatic Disease (RD); however, the higher incidence of RD is associated with "pathomorphic" phenotypic pictures, making the diagnosis more difficult. Chorea, carditis, arthritis, marginatum erythema are the major criteria for the diagnosis of RD and can represent its clinical onset, but likewise, due to the variety of their associations, they open a range of different differential diagnoses. Through the critical reasoning applied to some clinical cases, these major “criteria” of RD have been discussed to reduce the difficulties of the differential diagnosis.
Riassunto
La revisione dei criteri di Jones da parte dell’American Heart Association ha permesso l’identificazione e la diagnosi di un maggior numero di casi di Malattia Reumatica (MR); tuttavia la maggiore incidenza della MR si è associata a quadri fenotipici “patomorfici”, rendendo la diagnosi più complessa. La corea, la cardite, l’artrite, l’eritema marginato rappresentano un criterio maggiore per la diagnosi di MR e ne possono rappresentare l’esordio, ma parimenti, per la varietà delle loro associazioni, essi aprono un ventaglio di diagnosi differenziale. Attraverso il ragionamento critico applicato ad alcuni casi clinici, abbiamo discusso questi “criteri” maggiori di MR al fine di contribuire a ridurre le difficoltà della diagnosi differenziale.
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Suggerite dall'AI
Classificazione MeSH
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Corrispondenza: antonino.alberio@gmail.com