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In order to detect subclinical mild rheumatic inflammation, Metopirone, or SU-4885, was administered to patients with rheumatic heart disease, in an inactive stage of rheumatic fever. Metopirone lowers blood cortisol levels and activates suppressed inflammatory changes of the disease. Following Metopirone administration clinical manifestations, such as cardiac symptoms, arthralgia and fever, occurred in 3 of 8 patients with rheumatic heart disease, and blood sludge in the bulbar conjunctiva appeared or was enhanced in severity and range in 4 of them. These manifestations are considered to be due to subclinical inflammatory changes activated by Metopirone in rheumatic heart disease. The same procedure was performed in patients with rheumatoid arthritis, lupus erythematosus, and other diseases. Of 5 patients with rheumatoid arthritis, arthralgia was aggravated in 2 patients, cardiac symptoms occurred in 1, and enhancement of blood sludge in the bulbar onjunctiva was found in all of them.It was suggested that this procedure may aid to detect subclinical rheumatic activity in rheumatic heart disease, and to determine a valvular heart disease whether of rheumatic origin or not.

Activation of Subclinical Rheumatic Activity by Metopirone Administration in Rheumatic Heart Disease and Rheumatoid Arthritis