Difference between revisions of "IPLab:Lab 9:ARF"

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(Clinical Summary)
 
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== Clinical Summary ==  
 
== Clinical Summary ==  
 
This 21-year-old black male with sickle cell anemia had recurrent attacks of acute rheumatic fever beginning at age 14. Mitral insufficiency and stenosis were present by age 16. On prophylactic antibiotics, the patient had no evidence of recurrence until three weeks before his final admission, when an upper respiratory infection developed. A few weeks later he developed acute migratory polyarthritis. This was associated with rapid deterioration of cardiac function and death.
 
This 21-year-old black male with sickle cell anemia had recurrent attacks of acute rheumatic fever beginning at age 14. Mitral insufficiency and stenosis were present by age 16. On prophylactic antibiotics, the patient had no evidence of recurrence until three weeks before his final admission, when an upper respiratory infection developed. A few weeks later he developed acute migratory polyarthritis. This was associated with rapid deterioration of cardiac function and death.
 
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== Autopsy Findings ==
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At autopsy, the heart was enlarged--weighing 675 grams--especially the left atrium. Both the aortic and mitral valves showed fibrosis as well as the fresh, tiny verrucae characteristic of acute rheumatic fever.
At autopsy, the heart was enlarged--weighing 675 grams--especially the left atrium. Both the aortic and mitral valves showed fibrosis as well as the fresh, tiny verrucae characteristic of acute rheumatic fever.  
 
  
 
== Images ==
 
== Images ==
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File:IPLab9ARF6.jpg|This high-power photomicrograph of myocardium shows the cellular detail of another Aschoff body. In this case there appears to be a multinucleated Aschoff giant cell (arrow).  
 
File:IPLab9ARF6.jpg|This high-power photomicrograph of myocardium shows the cellular detail of another Aschoff body. In this case there appears to be a multinucleated Aschoff giant cell (arrow).  
 
</gallery>
 
</gallery>
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== Virtual Microscopy ==
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<peir-vm>IPLab9ARF</peir-vm>
  
 
== Study Questions ==
 
== Study Questions ==
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== Additional Resources ==
 
== Additional Resources ==
 
=== Reference ===
 
=== Reference ===
 
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* [http://emedicine.medscape.com/article/236582-overview eMedicine Medical Library: Rheumatic Fever]
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* [http://emedicine.medscape.com/article/808945-overview eMedicine Medical Library: Rheumatic Fever in Emergency Medicine]
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* [http://emedicine.medscape.com/article/333103-overview eMedicine Medical Library: Acute Rheumatic Fever]
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* [http://www.merckmanuals.com/professional/pediatrics/rheumatic_fever/rheumatic_fever.html Merck Manual: Rheumatic Fever]
  
 
=== Journal Articles ===
 
=== Journal Articles ===
 
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* American Heart Association Committee on Rheumatic Fever.  [http://dx.doi.org/10.1161/CIR.0000000000000205 Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography].  ''Circulation'' 2015 April 23; 131:1806-1818.
  
 
=== Images ===
 
=== Images ===
 
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* [{{SERVER}}/library/index.php?/tags/2153-streptococcus PEIR Digital Library: Streptococcus Images]
 
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* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#8 Webpath: Myocarditis]
== Related IPLab Cases ==
 
 
 
  
 
{{IPLab 9}}
 
{{IPLab 9}}
  
 
[[Category: IPLab:Lab 9]]
 
[[Category: IPLab:Lab 9]]

Latest revision as of 21:44, 9 July 2020

Clinical Summary[edit]

This 21-year-old black male with sickle cell anemia had recurrent attacks of acute rheumatic fever beginning at age 14. Mitral insufficiency and stenosis were present by age 16. On prophylactic antibiotics, the patient had no evidence of recurrence until three weeks before his final admission, when an upper respiratory infection developed. A few weeks later he developed acute migratory polyarthritis. This was associated with rapid deterioration of cardiac function and death.

At autopsy, the heart was enlarged--weighing 675 grams--especially the left atrium. Both the aortic and mitral valves showed fibrosis as well as the fresh, tiny verrucae characteristic of acute rheumatic fever.

Images[edit]

Virtual Microscopy[edit]

Study Questions[edit]


Additional Resources[edit]

Reference[edit]

Journal Articles[edit]

Images[edit]

Aortic insufficiency refers to the inability of the aortic valve to close properly, thus allowing regurgitation of blood into the left ventricle during diastole -- i.e., volume overload. Disease of the aortic valve leaflets is a common cause of insufficiency.

A normal heart weighs 300 grams (range: 270 to 360 grams).

Friable material is easily crumbled.

Autoimmune disorders involve an immune response directed at the host's own cells.