Abstract
OBJECTIVE
To evaluate the demographic characteristics, clinical findings, laboratory values, treatment responses and prognosis of patients who followed up with acute rheumatic fever (ARF) in pediatric cardiology clinic.
METHODS
Two hundred and four patients followed up with the diagnosis of ARF, between December 2004 and April 2009, were reviewed retrospectively from archive files.
RESULTS
46.5% of the patients were female and 53.5% were male. Mean age was 10.3 ± 2.8 years and the mean follow-up period was 26.8 ± 13.3 months. The majority of patients were between the ages of 6-15. Patients admitted to hospital most common in winter and spring months. While the most common presenting symptom was joint findings the most rare presenting symptom was the presence of subcutaneous nodules. The most common major finding (82.2%) was carditis and the most common minor finding was the rise of ASO (92.2%), respectively. The frequency of minor criterias of fever and arthralgia associated with carditis was found to be significantly higher than that of associated with the other major findings (p<0.05). Frequency of cardiac murmur, cardiomegaly and tachycardia increased when the grade of carditis increased (p<0,05). The frequency of minor criterias of fever, leukocytosis, elevated CRP levels associated with arthritis was found to be significantly higher than that of associated with the other major findings (p<0,05). Artritis and chorea were not seen concurrently in any of the patients. CRP increament was rarely seen in patients with chorea (p<0,05). Most commonly mitral valve was involved. During the follow up, reactivation was seen in 18,8% and 50% of the patients with reactivation did not take secondary preventive treatment properly. Reactivation occurred in 11% of the patients under proper secondary preventive treatment (p<0,05).
CONCLUSION
Acute rheumatic fever is still the most common acquired cardiologic disease in under-developed and developing countries despite its decreasing importance and disease frequency in developed countries.
