Rheumatic Heart Disease and Acute Glomerulonephritis Post Streptococcal Coexistence: Four Case Reports

Second Author pada Abstrak “Rheumatic Heart Disease and Acute Glomerulonephritis Post Streptococcal Coexistence : Four Case Reports”

 

Ditampilkan sebagai Poster Case Presentation pada 24^th ASEAN Federation Cardiology Congress (AFCC) in conjunction with 28^th Annual Scientific Meeting of Indoesian Heart Association (ASMIHA)

Rheumatic Heart Disease and Acute Glomerulonephritis Post Streptococcal Coexistence: Four Case Reports

P. R. Indrisia¹, A. I. Nurudinulloh¹, D. A. Putra¹, S. E. Nauli², H. Priatna², P. Rahasto²

¹General Practitioner, Tangerang General Hospital

²Department of Cardiology and Vascular Medicine, Tangerang General Hospital

Introduction

Rheumatic  heart disease ( RHD) and acute glomerulonephritis post streptococcal (AGNPS) are associated with group A Streptococcal Infection. They had difference strain but rarely found coexistence. It is not sure from difference strain or same strain.

Case Illustrations

Case 1

A 20 moths old boy was admitted to E.D with chief complaint dyspneu and oedema 2 days prior to admission. It was followed by swollen in the eyes, face, feets, and “dark tea” –like urine. Physical examination found hypertention (83/55 mmHg), rales, gallop, hepatomegaly, and pitting oedema. Laboratory findings showed anemia, hematuria, ASTO +200. Echocardiography showed EF 28%, MR Moderate, TR Mild.

Case 2

A 13 y.o girl was admitted to E.D with chief complaint swollen in the face and legs. It was followed by PND and DOE. Physical examination showed hypertention (130/95 mmHg), rales, and pansystolic murmur, ascites, and oedema. Laboratory findings showed hematuria, ASTO +200. Echocardiography showed EF 35%, LV Global Hypokinetic, Minimal pericardial effusion, TR Moderate, and apical thrombus.

Case 3

A 13 y.o boy was admitted to E.D with chief complaint swollen eyes and face. It was followed by PND and DOE. Physical examination found hypertention (180/120 mmHg), rales, gallop, and pitting oedema. Laboratory findings showed hematuria, ASTO +200. Echocardiopraphy showed EF 66%, minimal pericardial effusion, and normal leaflet.

Case 4

A 8 y.o girl was admitted to E.D with chief complaint swollen face. It was followed by “dark tea” –like urine, PND and DOE were denied. Physical examination found hypertension (120/80 mmHg), normal heart sound, ascites, and pitting oedema. Laboratory showed hematuria, ASTO +200. Echocardiography showed EF 25%, global hypokinetic, MR Mild, TR MIlad, and minimal pericardial effusion.

Discussion

RHD coexistence with acute  AGNPS is a rare condition. Further investigation is needed to analyse if the coexistence from different strain or same strain.