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Is the Postcommissurotomy Syndrome of Rheumatic Origin?

AMA Arch Intern Med. 1957;99(2):253-259. doi:10.1001/archinte.1957.00260020089013.
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Soon after mitral commissurotomy became a frequent procedure, a clinical syndrome characterized by the occurrence of recurrent febrile episodes associated with pleuritis, pericarditis, pneumonitis, and occasional joint pains was recognized. Janton1 (1952) was the first to call attention to this syndrome, which he called "pleuropericardial episodes." He considered it to be due to smoldering rheumatic activity, but found that direct evidence for this was lacking. In 1955 he wrote 2 that in 8 of 41 living patients, there had been repeated postoperative episodes certain to be regarded even without laboratory verification as rheumatic activation. Soloff 3 stated "Because of the frequency of this syndrome following mitral commissurotomy and its absence following any other non-rheumatic cardiac or pulmonary surgery, and because of the frequent cardiac involvement, the syndrome should be regarded as reactivation of rheumatic fever." At first, most opinion was in agreement with that of Janton and of Soloff,


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