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MedicineCardiology

Immune pathogenesis of acute rheumatic fever

THE CONTEXT
Acute rheumatic fever follows a delayed immune response to group A streptococcal infection.

Trigger and cross-reactivity

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The triggering infection is caused by Streptococcus pyogenes, a group A streptococcus.
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Streptococcal antigens cross-react with cardiac myosin and sarcolemmal membrane proteins.

Inflammatory injury

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Antibodies produced against streptococcal antigens cause inflammation in the endocardium, myocardium and pericardium, as well as the joints and skin.
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