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Acute rheumatic fever: 10-year single-center experience: clinical and laboratory findings, with subclinical carditis and treatment complications

Part of: Basic Science

Published online by Cambridge University Press:  31 August 2021

Lida Bulbul ,
Mehmet Bedir Akyol Open the ORCID record for Mehmet Bedir Akyol [Opens in a new window] ,
Hasret Ayyıldız Civan Open the ORCID record for Hasret Ayyıldız Civan [Opens in a new window] ,
Gizem Kara Elitok Open the ORCID record for Gizem Kara Elitok [Opens in a new window] ,
Sami Hatipoglu Open the ORCID record for Sami Hatipoglu [Opens in a new window] ,
Canan Hasbal Akkus Open the ORCID record for Canan Hasbal Akkus [Opens in a new window]  and
Ali Bulbul Open the ORCID record for Ali Bulbul [Opens in a new window]
Lida Bulbul
Affiliation:
Department of Pediatrics, University of Health Science, Bakırköy Sadi Konuk Education and Research Hospital, Istanbul, Turkey
Mehmet Bedir Akyol
Affiliation:
Department of Pediatrics, University of Health Science, Bakırköy Sadi Konuk Education and Research Hospital, Istanbul, Turkey
Hasret Ayyıldız Civan
Affiliation:
Department of Pediatrics, University of Health Science, Bakırköy Sadi Konuk Education and Research Hospital, Istanbul, Turkey
Gizem Kara Elitok
Affiliation:
Department of Pediatrics, University of Health Science, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
Sami Hatipoglu
Affiliation:
Department of Pediatrics, University of Health Science, Bakırköy Sadi Konuk Education and Research Hospital, Istanbul, Turkey
Canan Hasbal Akkus
Affiliation:
Department of Pediatrics, University of Health Science, Bakırköy Sadi Konuk Education and Research Hospital, Istanbul, Turkey
Ali Bulbul*
Affiliation:
Department of Pediatrics, University of Health Science, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Professor A. Bulbul, MD, Department of Pediatrics, University of Health Science, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey. Fax: +90 212 234 11 21. E-mail: drbulbul@yahoo.com
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Abstract

Background:

Acute rheumatic fever in childhood continues to cause serious morbidity despite all developments. The objective of this study was to evaluate the clinical and laboratory characteristics of patients with acute rheumatic fever and to determine the frequency of subclinical carditis and the side effects of the drugs used in the treatment.

Methods:

The data of patients hospitalised between 2008 and 2018 with the diagnosis of acute rheumatic fever were included in the study. The relationship of gender and age with the frequency of major symptoms and the distribution of the drugs used in the treatment and their side effects were evaluated.

Results:

Medical records of 102 patients with complete data were reviewed. 56.9% of the patients were male and the mean age was 10.7 ± 1.9 years. The most common distribution of complaints found were arthritis (51%), arthralgia (25.5%) and fever (16.7%). 10.8% of all patients (n = 11) were diagnosed subclinical carditis via echocardiographic evaluation. The frequency of carditis was higher in female patients with a borderline statistical significance (p = 0.05). However, there was no statistically significant difference between gender and arthritis (p = 0.22) and carditis (p > 0.05). Anti-congestive therapy was required in 22% and inotropic treatment was needed in 6.1% cases. Toxic hepatitis developed in four cases during the acetylsalicylic acid treatment.

Conclusions:

In a 10-year period, detection of subclinical carditis in 10.8% cases supported that echocardiography should be performed as a standard method for the diagnosis of acute rheumatic fever. Patients should be followed closely in terms of hepatic toxicity due to acetylsalicylic acid used in the treatment.

Keywords

Acute rheumatic feveracetylsalicylic acidarthritis childhoodsubclinical carditis
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1489 - 1494
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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