Pathophysiology of Rheumatic Fever

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Abstract
Radioisotopic technics were used to explore physiologic aberrations that may characterize individuals with acute rheumatic fever. No significant changes were noted in serial measurements of the blood volume or serum sodium and potassium concentrations. Most of the individuals with severe disease showed an initial value for radiosodium space of more than 330 ml./Kg. of body weight, with no evidence of edema. The exchangeable sodium content of the body correlated well with the radiosodium space. These changes are difficult to explain solely on the basis of extracellular edema, and are interpreted as suggesting that the intracellular content of sodium or that in bone is increased during acute rheumatic fever. An intracellular increase in sodium may be due to an alteration in the permeability of cell membrane induced by an immune mechanism.