Abstract
Objective. To evaluate the clinical associations between rheumatic fever and antiphospholipid syndrome and the impact of coexistence of these two diseases in an individual. Methods. Systematic review in electronics databases, regarding the period from 1983 to 2012. The keywords: “Rheumatic Fever,” “Antiphospholipid Syndrome,” and “Antiphospholipid Antibody Syndrome” are used. Results. were identified 11 cases described in the literature about the association of rheumatic fever and antiphospholipid syndrome. Clinical presentation of rheumatic fever was characterized by the predominance of carditis (11/11) and chorea (7/11). Regarding the manifestations of APS, the stroke was observed in 7/11 (63.6%), with one of them having probable embolic origin. Conclusion. The present study brings the information that the association between APS and RF is quite rare, however, is of great clinical importance. Doctors who deal with the RF should include in their differential diagnosis the APS, especially in the presence of stroke in patients with RF and whose echocardiogram does not show intracavitary thrombi.
Highlights
Rheumatic fever (RF) is a nonsuppurative late autoimmune inflammatory complication of Streptococcus pyogenes infection in the upper airway
Clinical presentation of rheumatic fever was characterized by the predominance of carditis (11/11) and chorea (7/11)
The aim of this study was to evaluate the clinical associations between rheumatic fever and antiphospholipid syndrome and the impact of coexistence of these two diseases in an individual. This is a systematic review of scientific papers that deal with the relationship between rheumatic fever and antiphospholipid syndrome
Summary
Rheumatic fever (RF) is a nonsuppurative late autoimmune inflammatory complication of Streptococcus pyogenes infection in the upper airway. This condition remains a public health problem in developing countries. Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombotic events and/or recurrent abortions in the presence of antiphospholipid antibodies (aPLs) [2]. RF and APS share clinical and pathophysiological manifestations, among which we highlight the carditis, chorea, arthritis, and thromboembolic events (mainly represented by stroke). APLs have been related to valve manifestations which are similar in both pathologies, as much from the standpoint echocardiographic as pathophysiological [3] (this paper showed a considerable overlap of humoral immunity in RF and APS, supporting the hypothesis of common pathogenic mechanisms between both diseases). Previous studies were able to demonstrate that aPLs are associated with the onset of chorea in APS [4, 5]
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