How to differentiate rheumatic fever?

Rheumatic fever mainly affects female patients, especially children. It was once one of the major diseases that endanger the life and health of school-age children and adolescents. The disease can have a great impact on the heart, joints, central nervous system and subcutaneous tissue, among which the impact on the heart and joints is the most obvious. Having rheumatic fever is a very painful thing. So, how do we differentiate and diagnose rheumatic fever?

There is currently no specific laboratory test for rheumatic fever. There are two main aspects to assist diagnosis: 1. Establish previous streptococcal infection;

② Clarify the existence and persistence of rheumatic activity process. Here's some evidence of rheumatic fever.

Evidence of a streptococcal infection

1. Throat swab culture is often positive for hemolytic streptococci. However, a positive culture cannot confirm whether it is from a previous infection or a different strain acquired during the course of the disease. For patients who have been treated with antibiotics, throat swab cultures may be falsely negative.

2. Serum hemolytic streptococcal antibody determination Hemolytic streptococci can secrete a variety of antigenic substances, causing the body to produce corresponding antibodies. The increase of these antibodies indicates that the patient has had a recent hemolytic streptococcal infection. Usually 2 to 3 weeks after streptococcal infection, antibodies increase significantly, gradually decrease after 2 months, and can last for about 6 months. Commonly used antibody assays include:

⑴ Antistreptolysin "O" ASO: 500 units is increased;

⑵ Anti-streptococcal kinase ASK: 80 units is increased;

⑶ Anti-hyaluronidase: 128 units is increased;

⑷Others include anti-deoxyribonuclease BADNA-B: anti-streptococcal enzyme and anti-M protein antibody assays.

2. Evidence of rheumatic inflammatory activity

1. The white blood cell count in a routine blood test is slightly to moderately elevated, with an increase in neutrophils and a left shift in the nucleus; there is often a slight decrease in the red blood cell count and hemoglobin content, showing normocytic and normochromic anemia.

2. Nonspecific changes in serum components Certain serum components may change in various inflammatory or other active diseases. It also tests positive during the acute or active phase of rheumatic fever. Commonly used measurement indicators are:

⑴ Erythrocyte sedimentation rate (ESR): ESR is accelerated, but it may not increase in patients with severe heart failure or after anti-rheumatic treatment with corticosteroids or salicylic acid preparations.

⑵C-reactive protein: There is a protein in the serum of patients with rheumatic fever that reacts to substance C and is present in alpha globulin. During the active period of wind, turbidity and dampness, C-reactive protein increases and recovers when the condition improves.

⑶Mucin: Mucin is a chemical component of the collagen tissue matrix. When rheumatism is active, collagen tissue is destroyed and the concentration of mucin in the serum increases.

⑷ Protein electrophoresis: Albumin is decreased, while α2 and γ globulins are often increased.

3. Immune index detection

⑴ Circulating immune complex detection is positive.

⑵ Serum total complement and complement C3: decreased during rheumatic activity.

⑶Immunoglobulins IgG, IgM, IgA: increased in the acute phase.

If both the antibody and specific serum component tests are positive, then it can be confirmed that the patient has rheumatic fever. If both are negative, then it is not the case. Patients and friends should maintain a normal mental state. It has been confirmed that mental stimulation and excessive sadness are also important causes of this disease. For many friends, emotional fluctuations after they get sick cause their condition to worsen, so it is important to maintain a normal mental state.