The difference between rheumatic fever and rheumatoid arthritis

Written by Yang Ya Meng
Rheumatology
Updated on September 03, 2024
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The main difference between rheumatic fever and rheumatoid arthritis is that in addition to symptoms of arthritis, rheumatic fever also presents with elevated anti-streptolysin O levels and valvular heart disease, with some patients displaying subcutaneous erythema and chorea-like symptoms. Rheumatoid arthritis, on the other hand, primarily manifests as joint pain, and rarely involves heart valve issues. Additionally, rheumatoid arthritis is characterized by elevated rheumatoid factor, anti-CCP antibodies, and anti-AkA antibodies as its main clinical features. Patients with rheumatoid arthritis also exhibit increased inflammatory markers. The key differences between rheumatic fever and rheumatoid arthritis lie in the different antibodies involved and the general association of rheumatic fever with cardiac involvement.

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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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Can people with rheumatic fever eat fish?

Patients with rheumatic fever can eat freshwater fish, but should try to eat less fish without scales and sea fish. For patients with rheumatic fever, the general dietary rule is to eat a light diet and reduce consumption of spicy, warming, oily, and rich foods. Foods such as celery, coriander, leeks, seaweed, mushrooms, beef, mutton, dog meat, and longan should be minimized. Seafood, such as shrimp and crab, which are high in protein, should also be consumed less. In addition to dietary considerations, patients with rheumatic fever should also avoid getting cold and pay attention to rest.

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Written by Yang Ya Meng
Rheumatology
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How to treat rheumatic fever?

Patients with rheumatic fever who develop a fever can first use non-steroidal anti-inflammatory drugs (NSAIDs) such as sustained-release diclofenac sodium tablets for symptomatic fever reduction. At the same time, it is also necessary to actively treat the primary disease of rheumatic fever. If the rheumatic fever is induced by a streptococcal infection, additional anti-infection treatment is also needed. Furthermore, as rheumatic fever is also an autoimmune disease, while using NSAIDs to reduce fever, it is also necessary to add some immunosuppressants, such as methotrexate or leflunomide, to control the condition. Only on the basis of controlling the condition can rheumatic fever potentially be completely cured. (The use of medications should be under the guidance of a doctor.)

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Written by Yang Ya Meng
Rheumatology
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Symptoms and Treatment of Rheumatic Fever

Patients with rheumatism often experience symptoms of upper respiratory tract infections in the early stages of the disease, such as fever and sore throat. Additionally, patients with rheumatism commonly exhibit migratory joint pain, primarily characterized by acute onset of redness, swelling, heat, pain, and limited mobility in the joints, but these can improve on their own. Patients with rheumatic fever often also suffer from carditis, which can include valvulitis, myocarditis, and pericarditis, with damage to the valves being the most common. Rheumatic fever may also present with ring-shaped erythema on the skin or subcutaneous nodules, and it can include chorea. The most common treatment for rheumatic fever is the intramuscular injection of penicillin. (Specific medication use should be carried out under the guidance of a doctor.)

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Written by Du Rui Xia
Obstetrics
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Symptoms of rheumatic fever in children

Children often show symptoms of rheumatic fever, which commonly leads to myocarditis, arrhythmias, palpitations, and asthma. Additionally, there can be changes in the skin, such as subcutaneous erythema nodosum, as well as joint swelling and pain. There are also general symptoms like fever, fatigue, cough, nosebleeds, abdominal pain, nausea, and vomiting, along with swelling of the lymph nodes throughout the body. During examinations, there is often a significant increase in C-reactive protein and elevated levels of anti-streptococcal antibodies and anti-O. Abnormalities can also be seen on the electrocardiogram. Once symptoms of pediatric rheumatic fever appear, it is crucial to promptly visit a hospital for diagnosis and timely treatment.