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DIFFERENTIATING ACUTE RHEUMATIC FEVER AND POST-STREPTOCOCCAL REACTIVE ARTHRITIS
Selections from Journal Watch Pediatrics and Adolescent Medicine
Copyright © 2009 Massachussetts Medical Society. All rights reserved.
ARF is more acute than is PSRA.
Both acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA) occur after streptococcal throat infections and are associated with symptoms of arthritis, but only ARF requires antibiotic prophylaxis to prevent recurrence. To examine clinical differences between ARF and PSRA and discern whether they are two distinct diseases or variants on an ARF spectrum, investigators retrospectively reviewed the medical charts of 68 children with ARF and 159 with PSRA (age, <16 years) from an Israeli rheumatology registry.
Patients with ARF had significantly higher erythrocyte sedimentation rates (ESR; mean, 92 vs. 57 mm/h) and C-reactive protein (CRP) levels (mean, 107 vs. 25 mg/L), significantly shorter durations of joint symptoms after starting anti-inflammatory therapy (mean, 2 vs. 7 days), and significantly lower rates of relapsing joint symptoms after discontinuation
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