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2016-07-26T01:14:08Z

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	~~#redirect~~ [[~~Heart_valves#Rheumatic_heart_disease~~]]		'''Rheumatic heart disease''', abbreviated '''RHD''', is a relatively uncommon [[heart valve]] pathology that follows ''rheumatic fever''.

			==General==
			*Classically leads to mitral valve stenosis.
			**Rheumatic fever accounts for 99% of mitral stenosis.<ref name=Ref_PBoD594>{{Ref PBoD\|594}}</ref>
			***Caused by ''Streptococcus pyogenes''.<ref name=pmid18306530>{{Cite journal \| last1 = Chopra \| first1 = P. \| last2 = Gulwani \| first2 = H. \| title = Pathology and pathogenesis of rheumatic heart disease. \| journal = Indian J Pathol Microbiol \| volume = 50 \| issue = 4 \| pages = 685-97 \| month = Oct \| year = 2007 \| doi = \| PMID = 18306530 }}</ref>
			*Disease less frequent today - as streptococcal pharynigits is treated with antibiotics.

			==Gross==
			*"Fish-mouth appearance".
			**Slit-like morphology; elliptical cross-sectional flow area (mitral valve) has an abnormally small semi-minor axis<ref>URL: [http://en.wikipedia.org/wiki/Ellipse http://en.wikipedia.org/wiki/Ellipse]. Accessed on: 13 November 2010.</ref> axis due to valve thickening.
			**Image: [http://www.principia-eng.com/services/construction/IMG_3098.jpg Fish-mouth appearance - pipe (principia-eng.com)].
			*Significant valvular thickening.
			*Thickening and shortening of the cordae tendinae.

			DDx:
			*Thickening of the cordae tendinae due to micronodular [[cirrhosis]].<ref name=Ref_AoGP25>{{Ref AoGP\|25}}</ref>

			===Images===
			<gallery>
			Image:Rheumatic_heart_disease,_gross_pathology_20G0013_lores.jpg \| RHD - showing valvular thickening and thickening of the cordae tendinae. (WC)
			Image:Aortic_stenosis_rheumatic,_gross_pathology_20G0014_lores.jpg \| RHD - showing valvular thickening - aortic valve. (WC)
			</gallery>
			==Microscopic==
			Features:<ref name=Ref_PBoD593>{{Ref PBoD\|593}}</ref>
			*Caterpillar cells ([[AKA]] Anitschkow cells)
			**Abundant eosinophilic cytoplasm.
			**Moderately-poorly defined cell border.
			**Well-defined central ovoid nucleus with a prominent wavy ribbon-like chromatin -- looks vaguely like a caterpillar with some imagination.
			**Pathognomonic for rheumatic fever.

			*Aschoff bodies - usually in the heart itself:
			**Jumbled collagen, eosinophilic.
			**Surrounded by lymphocytes (T cells) +/- plasma cells.

			Notes:
			*Anitschkow cells are thought to be histocytes and Aschoff bodies are thought to be [[granuloma]]s.<ref name=pmid3070554>{{Cite journal \| last1 = Love \| first1 = GL. \| last2 = Restrepo \| first2 = C. \| title = Aschoff bodies of rheumatic carditis are granulomatous lesions of histiocytic origin. \| journal = Mod Pathol \| volume = 1 \| issue = 4 \| pages = 256-61 \| month = Jul \| year = 1988 \| doi = \| PMID = 3070554 }}</ref>
			**This is disputed.<ref name=pmid10399163>{{Cite journal \| last1 = Stehbens \| first1 = WE. \| last2 = Zuccollo \| first2 = JM. \| title = Anitschkow myocytes or cardiac histiocytes in human hearts. \| journal = Pathology \| volume = 31 \| issue = 2 \| pages = 98-101 \| month = May \| year = 1999 \| doi = \| PMID = 10399163 }}</ref>

			===Images===
			<gallery>
			Image:Rheumatic_heart_disease_-_intermed_mag.jpg \| RHD - intermed. mag. (WC/Nephron)
			Image:Rheumatic_heart_disease_-_3_-_high_mag.jpg \| RHD - high mag. (WC/Nephron)
			Image:Rheumatic_heart_disease_-_3b_-_very_high_mag.jpg \| RHD - very high mag. (WC/Nephron)
			Image:Aschoff_Body_in_Rheumatic_Myocarditis.jpg \| Aschoff body (WC/Uthman)
			Image:Anitschkow_Myocytes_in_an_Aschoff_Body,_Rheumatic_Myocarditis.jpg \| Anitschkow myocytes (WC/Uthman)
			</gallery>
			===IHC===
			Features (Aschoff bodies & Anitschkow cells):<ref name=pmid3070554>{{Cite journal \| last1 = Love \| first1 = GL. \| last2 = Restrepo \| first2 = C. \| title = Aschoff bodies of rheumatic carditis are granulomatous lesions of histiocytic origin. \| journal = Mod Pathol \| volume = 1 \| issue = 4 \| pages = 256-61 \| month = Jul \| year = 1988 \| doi = \| PMID = 3070554 }}</ref>
			*S100 -ve.
			*Muscle specific actin -ve.
			*Desmin -ve.
			*NF -ve.
			*Vimentin +ve.
			*CD45 +ve (weak).

			==See also==
			*[[Heart valves]].

			==References==
			{{Reflist\|1}}

			[[Category:Cardiovascular pathology]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: redirect w/ cat.

2011-10-22T20:23:52Z

redirect w/ cat.

New page

#redirect [[Heart_valves#Rheumatic_heart_disease]]

[[Category:Diagnosis]]

Rheumatic heart disease - Revision history

Michael: split out

Michael: redirect w/ cat.