June 2, 1975

Acute Rheumatic Fever in Adults

Author Affiliations

From the Division of Rheumatology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Tex.

JAMA. 1975;232(9):925-928. doi:10.1001/jama.1975.03250090015009

Acute rheumatic fever (ARF) in 53 adults was characterized by a severe, febrile migratory polyarthritis involving primarily large joints in the lower extremities, with evidence of an antecedent streptococcal infection. Carditis, present in only eight (15%) of the adults, was mild and transient. The characteristic abnormality in laboratory findings was an erythrocyte sedimentation rate (Westergren) greater than 100 mm/hr. Response to high-dose aspirin therapy was prompt and dramatic in all patients. Mild and evanescent abnormalities of both renal function and hepatic function (not aspirin-mediated) were detected in 51% and 64%, respectively. A common disorder in San Antonio, ARF has distinctive symptoms. It can be readily diagnosed and promptly treated. In the adult, it is almost exclusively a syndrome of events severe but transient in the joints, and mild and transient in the heart, kidneys, and liver.

(JAMA 232:925-928, 1975)