Rheumatic Fever: Autoimmune Inflammatory Disease

Rheumatic fever is an autoimmune inflammatory disease that can develop as a complication of insufficient treatment of strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with group A streptococcus bacteria. Rheumatic fever is most prevalent in children ages 5- to 15-year-old, although it can develop in younger children and adults. Although strep throat is common, rheumatic fever is rare in the United States and other developed countries. Nevertheless, rheumatic fever remains common in developing areas of the world. One of the most serious lasting effects of Rheumatic fever is that children can develop rheumatic heart disease; this can cause permanent damage to the heart, including damaged heart valves and
Streptococcal proteins display molecular mimicry recognized by the immune system, especially bacterial M-proteins and human cardiac antigens such as myosin and valvular endothelium. Antimyosin antibody recognizes laminin, an extracellular matrix alpha-helix coiled protein, which is part of the valve basement membrane structure. The valves most affected by rheumatic fever, in order, are the mitral, aortic, tricuspid, and pulmonary valves. In most cases, the mitral valve is involved with 1 or more of the other 3. In acute disease, small thrombi form along the lines of valve closure. In chronic disease, there is thickening and fibrosis of the valve resulting in stenosis, or less commonly, regurgitation. T-cells that are responsive to the streptococcal M-protein infiltrate the valve through the valvular endothelium, activated by the binding of antistreptococcal carbohydrates with release or tumor necrosis factor (TNF) and interleukins (Burke, 2015).”
The symptoms of rheumatic fever commonly start about two to four weeks after being infected with the streptococcus bacteria. However, Rheumatic fever symptoms may vary from person to person; some people may have considerable amount of symptoms, while others only show signs of a few (Mayo Clinic, 2014).
Mayo Clinic has listed the signs and symptoms of Rheumatic fever, which result from inflammation
The health care provider may also order labs to confirm the streptococcus infection, along with ECG and echocardiography (Mayo Clinic, 2014).
One of the first goals in treatment of Rheumatic fever is the eradication of any remaining group A streptococcal bacteria, and to alleviate clinical manifestation associated with Rheumatic fever. This treatment would include antibiotic to treat the streptococcus infection. Following the initial round of antibiotic patients would then receive monthly doses of antibiotics for 3 to 5 years, to prevent any further recurrences. Anti-Inflammatory medication would be used to help alleviate the swelling that occurs in the muscle of the heart and also to relieve joint pain (Heart