Difference between Rheumatic Fever and Rheumatoid Arthritis

Written by Yang Ya Meng
Rheumatology
Updated on September 01, 2024
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The key difference between rheumatic fever and rheumatoid arthritis primarily lies in the fact that patients with rheumatic fever, besides exhibiting symptoms such as joint pain, also develop cardiac and dermatological manifestations. Patients with rheumatic fever may experience mitral stenosis and symptoms like erythema on the skin. Moreover, the examination of antibodies in rheumatic fever patients mainly shows an elevation in anti-streptolysin O antibody. In contrast, patients with rheumatoid arthritis typically display elevated rheumatoid factor, anti-CCP antibodies, and anti-AKA antibodies, and they seldom have skin or cardiac manifestations. Therefore, to differentiate rheumatic fever from rheumatoid arthritis, one can test for anti-streptolysin O and rheumatoid factor, and further conduct an echocardiogram to determine any cardiac involvement.

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Written by Yang Ya Meng
Rheumatology
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What foods should not be eaten with rheumatic fever?

Patients with rheumatoid fever should avoid the following three major categories of foods: The first category is vegetables, such as celery, coriander, leeks, seaweed, and mushrooms, which should be consumed in moderation. The second category includes meats like lamb, beef, and dog meat, which are very warming and nourishing and should be reduced in consumption. The third category includes seafood such as shrimp, crab, and sea cucumber, which are high in protein and should also be avoided. For patients with rheumatism, the general dietary principle is to follow a light diet, avoid spicy and dry-heat foods, and reduce greasy foods. For patients with rheumatic fever, it is particularly important during the acute phase to rest and avoid catching colds and infections.

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Written by Liu Li Ning
Rheumatology
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Can you drink alcohol with rheumatic fever?

Rheumatic fever should not involve alcohol consumption. Because drinking could potentially trigger a flare-up of rheumatic fever and worsen the symptoms. Rheumatic fever is an inflammatory disease caused by Group A beta-hemolytic streptococcal infection. Common clinical manifestations include fever, subcutaneous nodules, erythema marginatum, joint pain or arthritis, chorea, carditis, and so forth. During the acute phase, the main symptoms are fever and joint pain, which can be treated with penicillin antibiotics to combat infection. Joint pain can be relieved with non-steroidal anti-inflammatory drugs, such as etoricoxib. In cases where carditis occurs during the acute phase, combined treatment with corticosteroids is also required. Regarding diet, it is advisable to eat lightly, and both smoking and drinking alcohol should be avoided.

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Written by Yang Ya Meng
Rheumatology
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Is rheumatic fever prone to recurrence?

Rheumatic fever recurs because it is caused by an infection with Group A streptococcus. If the streptococcus is not completely eradicated, recurrence is likely. Therefore, it is critical for patients with rheumatic fever to undergo a full course of anti-infection treatment initially. The most commonly used treatments are antibiotics such as penicillin and second-generation cephalosporins. Additionally, long-acting benzathine penicillin treatment outside the hospital is necessary to completely eradicate the streptococcus, thereby preventing the recurrent episodes of rheumatic fever. If the streptococcus is well-controlled, the likelihood of recurrence of rheumatic fever will be relatively small.

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Written by Yang Ya Meng
Rheumatology
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Treatment of rheumatic fever with aspirin

Patients with rheumatic fever use aspirin primarily for its anti-inflammatory effects to reduce the inflammatory response. Aspirin also has analgesic properties that can be used to treat symptoms like joint pain associated with rheumatic fever. However, it is crucial to monitor patients taking aspirin for any gastrointestinal reactions, such as stomach pain or black stools. During the use of aspirin, it's important to be vigilant about these gastrointestinal symptoms. Additionally, medications that protect the stomach, such as pantoprazole which reduces stomach acid, can be used to prevent the side effects of aspirin. (Use medication under the guidance of a doctor.)

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Written by Yang Ya Meng
Rheumatology
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Treatment of acute rheumatic fever

The treatment of rheumatic fever includes general treatment, where patients are advised to rest in bed. The second is the use of antibiotics, aimed at eliminating streptococcal infections to prevent recurrent attacks of rheumatic fever. The third is anti-rheumatic treatment, with the preferred choice being non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. If the patient's rheumatic fever affects the heart, corticosteroid treatment is also required. In addition, to assist in the reduction of corticosteroids, some immunosuppressants need to be added, such as methotrexate and leflunomide, which help control the condition. For the treatment of complications of rheumatic disease, such as concurrent lung infection, antibiotic treatment should also be considered. (The use of medication should be under the guidance of a professional doctor.)