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Changing face of acute rheumatic fever in childhood and our clinical results

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 retrospect...

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Autores principales: Yavrum, Begum Erzurumlu, Gul, Ayse Esin Kibar, Azak, Emine, Gursu, Hazim Alper, Cetin, Ibrahim Ilker
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170381/
https://www.ncbi.nlm.nih.gov/pubmed/37181068
http://dx.doi.org/10.14744/nci.2021.58966
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author Yavrum, Begum Erzurumlu
Gul, Ayse Esin Kibar
Azak, Emine
Gursu, Hazim Alper
Cetin, Ibrahim Ilker
author_facet Yavrum, Begum Erzurumlu
Gul, Ayse Esin Kibar
Azak, Emine
Gursu, Hazim Alper
Cetin, Ibrahim Ilker
author_sort Yavrum, Begum Erzurumlu
collection PubMed
description 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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spelling pubmed-101703812023-05-11 Changing face of acute rheumatic fever in childhood and our clinical results Yavrum, Begum Erzurumlu Gul, Ayse Esin Kibar Azak, Emine Gursu, Hazim Alper Cetin, Ibrahim Ilker North Clin Istanb Orıgınal Article 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. Kare Publishing 2023-04-18 /pmc/articles/PMC10170381/ /pubmed/37181068 http://dx.doi.org/10.14744/nci.2021.58966 Text en © Copyright 2023 by Istanbul Provincial Directorate of Health https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Orıgınal Article
Yavrum, Begum Erzurumlu
Gul, Ayse Esin Kibar
Azak, Emine
Gursu, Hazim Alper
Cetin, Ibrahim Ilker
Changing face of acute rheumatic fever in childhood and our clinical results
title Changing face of acute rheumatic fever in childhood and our clinical results
title_full Changing face of acute rheumatic fever in childhood and our clinical results
title_fullStr Changing face of acute rheumatic fever in childhood and our clinical results
title_full_unstemmed Changing face of acute rheumatic fever in childhood and our clinical results
title_short Changing face of acute rheumatic fever in childhood and our clinical results
title_sort changing face of acute rheumatic fever in childhood and our clinical results
topic Orıgınal Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170381/
https://www.ncbi.nlm.nih.gov/pubmed/37181068
http://dx.doi.org/10.14744/nci.2021.58966
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