Feuer J, Spiera H
Department of Medicine, Mount Sinai Medical Center, New York, NY 10029-6574, USA.
J Rheumatol. 1997 Feb;24(2):337-40.
To describe a series of adults diagnosed with acute rheumatic fever (ARF).
Retrospective chart review of 14 patients age > 18 years with suspected ARF between 1990 and 1994 in a private rheumatology practice setting. Four additional patients treated at our medical center were included in the study.
Twelve patients met Jones criteria for rheumatic fever and were included in the study. Of these, only 3 had a childhood history of rheumatic fever. All had recent onset of arthritis and a history of antecedent sore throat. Only 4 patients, however, had throat cultures positive for B-hemolytic streptococcus. Nine patients were Hasidic Jews. Four patients had carditis. One patient had erythema marginatum, while chorea and subcutaneous nodules were not seen. Nine patients improved taking nonsteroidal antiinflammatory drugs or acetylsalicylic acid; 3 required steroid treatment to control severe arthritis.
Our clinical experience suggests that ARF occurs frequently, especially among Hasidic Jewish adults. Due to the disabling nature of the arthritis and the significant incidence (33%) of carditis, strict adherence to penicillin prophylaxis guidelines is indicated.
描述一系列被诊断为急性风湿热（ARF）的成年人。
对1990年至1994年在一家私立风湿病诊所中14名年龄大于18岁疑似ARF的患者进行回顾性病历审查。本研究纳入了另外4名在我们医疗中心接受治疗的患者。
12名患者符合风湿热的琼斯标准并被纳入研究。其中，只有3人有风湿热的儿童病史。所有人近期均有关节炎发作且有前驱咽痛病史。然而，只有4名患者的咽喉培养物中B型溶血性链球菌呈阳性。9名患者是哈西德派犹太人。4名患者有心脏炎。1名患者有边缘性红斑，未观察到舞蹈病和皮下结节。9名患者服用非甾体抗炎药或阿司匹林后病情改善；3名患者需要类固醇治疗以控制严重关节炎。
我们的临床经验表明，ARF经常发生，尤其是在哈西德派犹太成年人中。由于关节炎的致残性以及心脏炎的高发病率（33%），表明应严格遵守青霉素预防指南。
