Case report

Concurrent rheumatic fever and acute post-streptococcal glomerulonephritis in a high-burden setting

Anna V. Nakauyaca, Anna P. Ralph, William S. Majoni, Nadarajah Kangaharan

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A Streptococcus (Strep A) triggered both autoimmune sequelae. Salient features included mitral and aortic regurgitation that worsened during the acute illness, painful pericarditis, and high troponin; severe acute kidney injury with oliguria, hematuria, and macroalbuminuria; reduced complement (C3); and elevated streptococcal serology. The case highlights important diagnostic and management challenges. It also illustrates the serious morbidity impact of the complications of Strep A.

    Original languageEnglish
    Pages (from-to)1054-1057
    Number of pages4
    JournalAmerican Journal of Tropical Medicine and Hygiene
    Volume101
    Issue number5
    DOIs
    Publication statusPublished - 1 Jan 2019

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    Oliguria
    Complement C3
    Troponin
    Pericarditis
    Aortic Valve Insufficiency
    Rheumatic Fever
    Mitral Valve Insufficiency
    Hematuria
    Serology
    Glomerulonephritis
    Streptococcus
    Acute Kidney Injury
    Morbidity

    Cite this

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    abstract = "We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A Streptococcus (Strep A) triggered both autoimmune sequelae. Salient features included mitral and aortic regurgitation that worsened during the acute illness, painful pericarditis, and high troponin; severe acute kidney injury with oliguria, hematuria, and macroalbuminuria; reduced complement (C3); and elevated streptococcal serology. The case highlights important diagnostic and management challenges. It also illustrates the serious morbidity impact of the complications of Strep A.",
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    Case report : Concurrent rheumatic fever and acute post-streptococcal glomerulonephritis in a high-burden setting. / Nakauyaca, Anna V.; Ralph, Anna P.; Majoni, William S.; Kangaharan, Nadarajah.

    In: American Journal of Tropical Medicine and Hygiene, Vol. 101, No. 5, 01.01.2019, p. 1054-1057.

    Research output: Contribution to journalArticleResearchpeer-review

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    T2 - Concurrent rheumatic fever and acute post-streptococcal glomerulonephritis in a high-burden setting

    AU - Nakauyaca, Anna V.

    AU - Ralph, Anna P.

    AU - Majoni, William S.

    AU - Kangaharan, Nadarajah

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