salicylates and Myocarditis

Rheumatic fever and rheumatic heart disease continue unabated in most of the developing nations, affecting young individuals. Focal outbreaks of smaller magnitude have also been reported since mid 1980s from industrialized western nations, where this disease had almost disappeared. Introduction of penicillin in mid 1940s had markedly changed the natural history of rheumatic fever, although the incidence of rheumatic fever declined in developed nations before that, due to better living conditions. Treatment of rheumatic fever chiefly involves use of antibiotics (penicillin) to eradicate streptococci, and anti-inflammatory drugs like salicylates or corticosteroids. Patients with severe carditis, congestive heart failure and/or pericarditis are best treated with corticosteroids as these are more potent anti-inflammatory agents than salicylates. Salicylates may be sufficient for cases with mild or no carditis. The treatment must be continued for 12 weeks. Several studies have shown that valvular regurgitation, and not myocarditis, is the cause of congestive heart failure in active rheumatic carditis. Therefore surgery with mitral valve replacement or repair is indicated in cases with intractable hemodynamics due to mitral regurgitation. Development of chronic valvular lesion after an episode of rheumatic fever is dependent upon presence or absence of carditis in the previous attack and compliance with secondary prophylaxis. Recurrences due to inadequate penicillin prophylaxis are responsible for hemodynamically significant chronic valvular lesions requiring surgery.

Topics: Adrenal Cortex Hormones; Humans; Myocarditis; Rheumatic Heart Disease; Salicylates

Topics: Adrenal Cortex Hormones; Controlled Clinical Trials as Topic; Echocardiography; Follow-Up Studies; Heart Auscultation; Humans; Meta-Analysis as Topic; Myocarditis; Rheumatic Heart Disease; Salicylates; Sensitivity and Specificity

The effect of salicylates or indomethacin usage during viral infection was investigated in a murine model of coxsackievirus B3 myocarditis. Eighty-two 3-week-old CD1 mice received 3 x 10(5) median tissue culture infective dose (TCID50) of coxsackievirus B3 intraperitoneally. Then they received salicylates, indomethacin, or saline solution daily for 10 days. Mortality, viral and antibody titers, interferon levels, and pathologic changes in the heart were compared. Mortality (2/33, 4/15, and 0/34, respectively) and virus titers (10(4.72), 10(4.78), and 10(3.4) TCID50, respectively) were higher, interferon levels (300, 267, and 980 IU, respectively) were lower, and pathologic changes were worse in treated animals (antibody titers were similar). These findings indicate that nonsteroidal anti-inflammatory agents adversely affect the course of acute coxsackievirus B3 murine myocarditis. Determination of the pathogenesis of this deleterious effect requires thorough evaluation of virus-host interactions.

Topics: Animals; Antibodies, Viral; Coxsackievirus Infections; Indomethacin; Interferons; Mice; Myocarditis; Salicylates; Salicylic Acid

Topics: Adult; Arthritis, Juvenile; Biopsy; Drug Therapy, Combination; Endocardium; Humans; Indomethacin; Male; Myocarditis; Prednisone; Salicylates

Topics: Bed Rest; Dexamethasone; Humans; Myocarditis; Penicillins; Prednisolone; Rheumatic Fever; Salicylates

A boy, 2 years old, developed a HUS after a pneumonitis. He was treated with Heparin, salicylates and recurrent peritoneal dialysis and recovered slowly. The course of the disease was complicated by myocarditis, gastric hemorrhage and severe neurologic disturbances. 7 days after unset of hemolysis a cold agglutinin titer of 1:256 was detected. This fact arises the question whether infection with Mycoplasma pneumoniae and the presence of cold agglutinins in serum could be involved in the development of HUS. The possibility of a viral etiology for this disease is discussed.

Topics: Agglutinins; Child, Preschool; Cold Temperature; Gastrointestinal Hemorrhage; Hemolysis; Hemolytic-Uremic Syndrome; Heparin; Humans; Lung Diseases; Male; Mycoplasma Infections; Myocarditis; Nervous System Diseases; Peritoneal Dialysis; Salicylates

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Arabia; Child; Erythema Nodosum; Female; Humans; Male; Middle Aged; Myocarditis; Rheumatic Fever; Rheumatic Heart Disease; Salicylates

Topics: Adrenal Cortex Hormones; Age Factors; Child; Child, Preschool; Chorea; Endocarditis; Female; Heart Failure; Heart Valve Diseases; Humans; Male; Myocarditis; Penicillins; Rheumatic Fever; Rheumatic Heart Disease; Salicylates; Sex Factors

Topics: Adolescent; Adrenal Cortex Hormones; Aminopyrine; Child; Drug Therapy; Endocarditis; Humans; Infant; Myocarditis; Pericarditis; Rheumatic Heart Disease; Salicylates

Topics: Adrenocorticotropic Hormone; Cortisone; Dexamethasone; Humans; Myocarditis; Penicillins; Phenylbutazone; Prednisone; Rheumatic Fever; Rheumatic Heart Disease; Salicylates; Streptococcal Infections; Triamcinolone

Topics: Follow-Up Studies; Humans; Myocarditis; Rheumatic Heart Disease; Salicylates; Salicylic Acid

Topics: Adolescent; Aortic Valve; Aortic Valve Stenosis; Child; Follow-Up Studies; Heart Valve Diseases; Humans; Mitral Valve; Mitral Valve Stenosis; Myocarditis; Rheumatic Heart Disease; Salicylates

Topics: Electrocardiography; Epinephrine; Myocarditis; Pharmacology; Radiation Effects; Rats; Research; Salicylates; Streptococcal Infections; X-Rays

Topics: Adrenal Cortex Hormones; Myocarditis; Rheumatic Diseases; Rheumatic Fever; Rheumatic Heart Disease; Salicylates

Topics: Adrenocorticotropic Hormone; Aspirin; Cortisone; Myocarditis; Rheumatic Fever; Rheumatic Heart Disease; Salicylates

Topics: Adrenocorticotropic Hormone; Cortisone; Myocarditis; Rheumatic Fever; Salicylates

Topics: Chronic Disease; Cortisone; Myocarditis; Recurrence; Rheumatic Heart Disease; Salicylates

Topics: Humans; Lung Diseases; Myocarditis; Pulmonary Edema; Rheumatic Heart Disease; Salicylates; Sodium Salicylate

Topics: Anti-Bacterial Agents; Cortisone; Dermatologic Agents; Myocarditis; Rheumatic Heart Disease; Salicylates

Topics: Adrenocorticotropic Hormone; Cortisone; Myocarditis; Rheumatic Heart Disease; Salicylates

Topics: Animals; Flavones; Myocarditis; Quercetin; Rabbits; Salicylates; Sodium Salicylate

Topics: Animals; Lagomorpha; Myocarditis; Rabbits; Salicylates; Sodium Salicylate

Topics: Heart Diseases; Inactivation, Metabolic; Myocarditis; Rheumatic Fever; Rheumatic Heart Disease; Salicylates