Acute Rheumatıc Fever

KÖKSAL, Ali Osman; SOYLU, Asiye GÜLTEKİN; Özdemir, Osman

doi:10.12956/tjpd.2015.182

Cited by 3 publications

(5 citation statements)

References 49 publications

(92 reference statements)

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“…The female-to-male ratio was 1.22. Similar to the literature, the majority of the patients presented in winter (31.3%) and spring (27.5%), when infections are more common [ 18 , 20 – 25 ]. The literature reports different prevalences for different minor findings such as 54.6–81.1% for arthralgia, 40–62% for fever, 15.9–23% for prolonged PR interval, 81.8–95% for elevated ESR, and 72–81.8% for elevated CRP [ 26 , 27 ].…”

Section: Discussionsupporting

confidence: 83%

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Changing Face of Acute Rheumatic Fever in Childhood and Our Clinical Results

Yavrum¹

2021

North Clin Istanbul

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OBJECTIVE This study aims to evaluate the demographic and clinical findings of acute rheumatic fever (ARF) patients followed up in our clinic, their responses to treatment, and prognoses and to determine the clinical utility of echocardiography (ECHO) in the diagnosis of ARF. METHODS We retrospectively evaluated the data of 160 patients with ARF (6–17, mean 11.7±2.3 years, F/M: 88/72) that was diagnosed according to the Jones criteria and followed up in the pediatric cardiology clinic between January 2010 and January 2017. RESULTS About 29.4% (n=47) of 104 patients with rheumatic heart disease (RHD) had subclinical carditis. It was observed that subclinical carditis was most common in patients with polyarthralgia (52.2%); in contrast, clinical carditis was most commonly observed together with chorea (39%) and polyarthritis (37.1%). It was found that 60% (n=96) of the patients with rheumatic fever were between the ages of 10–13 and 31.3% (n=50) presented arthralgia most frequently in the winter months. The most common concomitant major symptoms were carditis + arthritis (35%) and carditis + chorea (19.4%). In patients with carditis, the most affected valves were mitral (63.8%) and aortic (50.6%) valves, respectively. The prevalence of monoarthritis, polyarthralgia, and subclinical carditis increased in cases diagnosed during and after 2015. The cardiac valve involvement findings of 71 of 104 patients (68.2%) with carditis improved during the approximately 7 years of follow-up. The regression of heart valve symptoms was significantly higher in patients with clinical carditis and those that complied with prophylaxis compared to patients with subclinical carditis and those that did not comply with prophylaxis. CONCLUSION We conclude that ECHO results should be included in the diagnostic criteria of ARF, and that subclinical carditis is associated with a risk of developing permanent RHD. Secondary prophylaxis non-compliance is significantly associated with recurrent ARF, and early prophylaxis can reduce the prevalence of RHD in adults and potential associated complications.

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Section: Discussionsupporting

confidence: 83%

“…Although rheumatic fever frequently affects patients aged between 5 and 15, studies report ARF attacks in patients aged 2–45 years [ 7 , 18 – 20 ]. In our study, the mean age of the subjects was 11.7±2.3 years, and 60% were aged 10–13.…”

Section: Discussionmentioning

confidence: 99%

Changing Face of Acute Rheumatic Fever in Childhood and Our Clinical Results

Yavrum¹

2021

North Clin Istanbul

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“…Expert agreement has been obtained regarding the idea of subclinical carditis, and ECHO has been widely used in the clinical evaluation of rheumatic carditis, gradually increasing its importance in the diagnosis of ARF over time [2,7,17]. In our study, we found that the prevalence of carditis, especially subclinical carditis, has increased and that these individuals have an increased chance of acquiring permanent rheumatic carditis.…”

Section: Discussionsupporting

confidence: 52%

“…Based on ECHO data, a WHO expert committee accepted previously published criteria for the diagnosis of rheumatic carditis [17]. Those with an ECHO diagnostic of valvular insu ciency but no audible murmur were labeled as having "subclinical" or "silent" carditis.…”

Section: Selection Of Patientsmentioning

confidence: 99%

Cardiac symptoms associated with rheumatic fever in children who visited Damascus Hospital between 2013 and 2020

Alkheder,

Alabdullah,

Nabulsi

2024

Preprint

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Background In addition to assessing the clinical results and prognosis of patients with acute rheumatic fever treated in the Cardiology Clinic at Damascus Hospital, this study intends to ascertain the clinical usefulness of echocardiography (ECHO) in the diagnosis of acute rheumatic fever. Methods and materials: A retrospective analysis was conducted on 160 ARF (6–17) patients, with a mean age of 11.7 ± 2.3 years, 88/72 female and male diagnoses based on Jones criteria, who were monitored in the cardiology clinic at Damascus Hospital from October 2013 to December 2020. Results Of the 104 patients diagnosed with rheumatic heart disease (RHD), approximately 29.4% had subclinical carditis; in contrast, clinical carditis was frequently associated with chorea (39%) and polyarthritis (37.1%). Sixty-six percent of patients with rheumatic fever were found to be between the ages of 10 and 13; thirty-three percent (n = 50) reported having frequent arthralgia during the winter, and the most common associated symptoms were carditis + arthritis (35%) and carditis + chorea (19.4%). When it came to carditis sufferers, it was The aortic (50.6%) and mitral (63.8%) valves were the most commonly impacted, respectively. In cases diagnosed during and after 2015, the prevalence of subclinical carditis, arthralgia, and uniarthritis rose and 71 out of 104 individuals saw an improvement in their valvular heart disease result. Individuals with carditis (68.2%) Patients with clinical carditis and those who followed prophylactic treatment had a significantly higher rate of regression of heart valve symptoms over the course of around 7 years of follow-up compared to patients with subclinical carditis and those who did not follow prophylactic treatment. Conclusion We conclude that early prophylaxis can reduce the prevalence of adult RHD and complications, subclinical carditis is associated with the risk of permanent RHD, and nonadherence to secondary prophylaxis is significantly associated with recurrent ARF. Additionally, ECHO findings should be included in the diagnostic criteria for ARF. potential connected to it.

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“…In Turkey, ARF is the most common cause of valvular heart disease (36) . In the present study, we preferred to treat patients with carditis showing inflammation with corticosteroids as many physicians have done (37) with the hope of preventing a major cause of morbidity and mortality in the young population.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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Objective: Our aim is to evaluate patients being referred with an initial diagnosis of chorea according to their clinical, laboratory features and final diagnoses while emphasizing cardiological findings of patients with Sydenham chorea. Method: Children aged 4-18 years who were referred to Okmeydanı Research and Training Hospital Pediatric Neurology department with an initial diagnosis of acute, subacute chorea between January 2017-January 2020 were retrospectively included. Chronic chorea and diseases associated with chronic chorea were excluded from the study. Data concerning clinical, laboratory features, cardiological findings, etiologies, treatments, recurrence rates and follow-ups of patients were recorded. Descriptive statistical analysis were performed using SPSS 21.0. Results: Fifteen patients has been referred with the initial diagnosis of chorea. Mean age of the patients was 11.5±2.2 years. Ten (67%) patients were females, 5 (33%) patients were male. After admission, 8 (54%) patients were diagnosed with Sydenham chorea, and 2 (13%) patients with recurrent Sydenham chorea. During physical examination, 5 (33%) patients did not have chorea, and 3 cases had tic disorder. Out of 8 patients with new diagnosis of Sydenham chorea, 3 (37.5%) patients had subclinical carditis, and 5 (62.5%) patients clinical carditis. Chorea had been treated with one of haloperidol/biperiden, valproic acid and prednisolon options. The treatment of 6 patients attending regular follow-up visits was stopped 2-6 months later. Chorea of two patients recurred during our follow-up, and one of our newly diagnosed Sydenham chorea patients had been recognized as antiphospholipid antibody syndrome after recurrence. Conclusion: Sydenham chorea is the most common cause of acquired chorea in childhood. Most of the time it is self limiting. Differential diagnosis of chorea must be kept in mind especially when there is a recurrence.

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Acute Rheumatıc Fever

Cited by 3 publications

References 49 publications

Changing Face of Acute Rheumatic Fever in Childhood and Our Clinical Results

Changing Face of Acute Rheumatic Fever in Childhood and Our Clinical Results

Cardiac symptoms associated with rheumatic fever in children who visited Damascus Hospital between 2013 and 2020

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

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