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New Zealand guidelines for the diagnosis of acute rheumatic fever: small increase in the incidence of definite cases compared to the American Heart Association Jones criteria.
[acute rheumatic fever]
The
aim
of
the
study
was
to
compare
utilisation
of
the
New
Zealand
guidelines
for
the
diagnosis
of
acute
rheumatic
fever
(
ARF
)
compared
to
the
American
Heart
Association
Jones
criteria
in
a
cohort
of
childrenRetrospective
review
of
79
consecutive
hospital
diagnosed
cases
of
ARF
referred
for
secondary
penicillin
prophylaxis
.
The
2006
New
Zealand
guidelines
for
ARF
were
applied
to
the
cohort
and
the
diagnostic
classification
compared
to
classification
using
the
American
Heart
Association
1992
Jones
criteria
.
Cases
were
defined
as
definite
,
probable
,
possible
or
not
ARF
.
The
New
Zealand
guidelines
use
subclinical
(
echocardiographic
)
carditis
as
a
major
criterion
of
ARF
.
Monoarthritis
,
if
associated
with
anti-
inflammatory
medicine
usage
likely
preventing
polyarthritis
,
is
also
accepted
as
a
major
criterion
.
Sixty
-
six
cases
were
considered
to
be
possible
,
probable
or
definite
first
episode
of
occurrence
ARF
.
Utilisation
of
the
New
Zealand
guidelines
resulted
in
16
%
(
CL
7
-
29
%
)
more
cases
defined
as
definite
ARF
than
using
American
Heart
Association
1992
Jones
criteria
(
59
/
66
cases
vs
51
/
66
cases
)
.
Polyathritis
was
the
most
frequent
presenting
symptom
.
Of
those
classified
as
definite
ARF
,
11
%
had
monoarthritis
with
anti-
inflammatory
usage
.
Clinical
carditis
was
present
in
55
%
and
subclinical
carditis
in
30
%
.
The
utilisation
of
subclinical
carditis
as
a
major
criterion
influenced
the
diagnosis
to
become
definite
ARF
in
8
%
of
the
cohort
only
,
as
the
remainder
had
polyarthritis
or
Sydenham
's
chorea
as
a
major
criterion
.
Utilisation
of
New
Zealand
guidelines
for
the
diagnosis
of
ARF
result
in
a
modest
increase
(
16
%
)
in
cases
classified
as
definite
ARF
compared
to
the
1992
Jones
criteria
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated
