Multisystem inflammatory illness resulting from an autoimmune response to GAS

Early phase(1-3wks): ARF - Fever, pancarditis, skin, joint & brain inflammation Late (decades): RHD - Recurrent endocarditis, valve scarring, CHF

Demographics

• children 5-15 due to early exposure to environmental risks
• females more common

Aetiology

1. Genetic factor: (unknown HLA)
2. Environmental: GAS (pharyngitis/impetigo), poor hygiene/sanitation, overcrowding
3. Auto-Immunity: (Anti DNAase)

Risk Factors

• Genetic predisposition
• ATSI
• Poor hygiene
• Overcrowding
• Poor sanitation
• Low health literacy