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Incidence and clinical features of acute rheumatic fever in Kayseri, Central Anatolia, 1998–2011

Published online by Cambridge University Press:  06 June 2014

Nazmi Narin
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Fatma Mutlu
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Mustafa Argun*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Abdullah Ozyurt
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ozge Pamukcu
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ali Baykan
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Zeynep Baykan
Affiliation:
Department of Medical Education, Erciyes University Medical Faculty, Kayseri, Turkey
Kazım Uzum
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
*
Correspondence to: Dr M. Argun, Erciyes University Medical Faculty, 38039, Department of Pediatrics, Kayseri, Turkey. Tel: +90 352 2076666; Fax: +90 352 4375825; E-mail: dr.margun@hotmail.com

Abstract

Background

In developing countries, acute rheumatic fever is the most common cause of acquired heart disease in the paediatric and adolescent population. It is believed that vulnerability to developing acute rheumatic fever is associated with several factors such as socio-economic and living conditions.

Aim

Determine the incidence and clinical characteristics of acute rheumatic fever in the Central Anatolia region of Kayseri within the last 14 years, and to make a comparison of two 7-year periods.

Material and methods

We performed a retrospective analysis of 624 patients who were diagnosed with acute rheumatic fever at the Department of Pediatric Cardiology in the Medical Faculty of Erciyes University between January, 1998 and December, 2011.

Results

The mean age of patients was 10.9±2.7 years. The female/male ratio was 1.4. When patients were categorised according to age groups, the largest group represented 376 patients (60.3%) aged between 10 and 14 years. The estimated incidence rate of acute rheumatic fever was 7.4/100,000 in the Central Anatolia region of Kayseri. Among the major findings, the most common included carditis at 54%, arthritis at 35%, Sydenham’s chorea at 25%, and subcutaneous nodules at 0.5%, respectively. No significant difference was found between the first 7-year period and second 7-year period in distributions of age, gender, and major findings.

Conclusion

Although there has been socio-economic development in Turkey in the recent years, the incidence of acute rheumatic fever is still high in the Central Anatolia region of Kayseri.

Type
Original Articles
Copyright
© Cambridge University Press 2014 

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References

1. Dajani, AS, Ayoub, E, Bierman, FZ, et al. Guidelines for the diagnosis of rheumatic fever: Jones criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association. JAMA 1992; 268: 20692073.CrossRefGoogle Scholar
2. Carapetis, JR, McDonalds, M, Wilson, NJ. Acute rheumatic fever. Lancet 2005; 366: 155168.Google Scholar
3. Marijon, E, Mirabel, M, Celermajer, DS, Jouven, X. Rheumatic heart disease. Lancet 2012; 379: 953964.Google Scholar
4. Miyake, CY, Gauvreau, K, Tani, LY, Sundel, RP, Newburger, JW. Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever. Pediatrics 2007, 120: 503508.Google Scholar
5. Barry, H. Rheumatic fever and rheumatic heart disease. World Health Organ Tech Rep Ser 2004; 923: 1122.Google Scholar
6. Tani, LY. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll DJ, Shaddy RE, Felte TF (eds). Moss and Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adults, 7th edn. Lippincott Williams & Wilkins, Philadelphia, 2008: 12561280.Google Scholar
7. Marijon, E, Celermajer, DS, Tafflet, M, et al. Rheumatic heart disease screening by echocardiography, the inadequacy of World Health Organization criteria for optimizing the diagnosis of subclinical disease. Circulation 2009; 120: 663668.Google Scholar
8. Tibazarwa, KB, Volmink, JA, Mayosi, BM. Incidence of acute rheumatic fever in the world: a systemic review of population-based studies. Heart 2008; 94: 15341540.Google Scholar
9. Saraclar, M, Ertugrul, A, Ozme, S. Akut romatizmal ateş insidansı ve romatizmal kalp hastalıkları prevelansı. Türk Kard Dern Arş 1978; 7: 5054.Google Scholar
10. Beyazova, U, Benli, D, Beyazova, M. Akut romatrizmal ateş görülme sıklığı. Çocuk Sağ Hast Derg 1987; 2: 7680.Google Scholar
11. Orun, UA, Ceylan, O, Bilici, M, et al. Acute rheumatic fever in the Central Anatolia region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012; 171: 361368.Google Scholar
12. Breda, L, Marzetti, V, Gaspari, S, Del Torto, M, Chiarelli, F, Altobelli, E. Population – based study of incidence and clinical characteristics of rheumatic fever in Abruzzo, central Italy, 2000–2009. J Pediatr 2012; 160: 832836.Google Scholar
13. Olgunturk, R, Canter, B, Tunaoglu, FS, Kula, S. Review of 609 patients with rheumatic fever in terms of revised and updated Jones criteria. Int J Cardiol 2006; 112: 9198.Google Scholar
14. Karaaslan, S, Oran, B, Reisli, I, Erkul, I. Acute rheumatic fever in Konya, Turkey. Pediatr Int 2000; 42: 7175.Google Scholar
15. Ozer, S, Hallioğlu, O, Ozkutlu, S, Celiker, A, Alehan, D, Karagöz, T. Childhood acute rheumatic fever in Ankara, Turkey. Turk J Pediatr 2005; 47: 120124.Google Scholar
16. Qurashi, MA. The pattern of acute rheumatic fever in children: experience at the children’s hospital, Riyadh, Saudi Arabia. J Saudi Heart Assoc 2009; 21: 215220.Google Scholar
17. Bitar, FF, Hayek, P, Obeid, M, Gharzeddine, W, Mikati, M, Dbaibo, GS. Rheumatic fever in children: a 15-year experience in a developing country. Pediatr Cardiol 2000; 21: 119122.Google Scholar
18. Tani, LY, Veasy, G, Minich, LL, Shaddy, RE. Rheumatic fever in children younger than 5 years: is the presentation different? Pediatrics 2003; 112: 10651068.Google Scholar
19. Narin, N, Kütükçüler, N, Ozyürek, R, Bakiler, AR, Parlar, A, Arcasoy, M. Lymphocyte subsets and plasma IL-1 alpha, IL-2, and TNF-alpha concentrations in acute rheumatic fever and chronic rheumatic heart disease. Clin Immunol Immunopathol 1995; 77: 172176.Google Scholar
20. Narin, N, Kütükçüler, N, Narin, F, Keser, G, Doganavsargil, E. Anticardiolipin antibodies in acute rheumatic fever and chronic rheumatic heart disease: is there a significant association? Clin Exp Rheumatol 1996; 14: 567569.Google Scholar
21. Kruhara, DK, Grandinetti, A, Galario, J, et al. Ethnic differences for developing rheumatic fever in a low-income group living in Hawaii. Ethn Dis 2006; 16: 357361.Google Scholar
22. Lee, JF, Naguwa, SM, Cheema, GS, Gershwin, ME. Acute rheumatic fever and its consequences: a persistent threat to developing nations in the 21st century. Autoimmun Rev 2009; 9: 117123.Google Scholar
23. Cimen, O, Oran, B, Cimen, D, et al. Release of N-terminal pro-brain natriuretic peptide in children with acute rheumatic carditis. Cardiol Young 2010; 20: 297301.Google Scholar
24. Veasy, LG, Tani, LY, Hill, HR. Persistence of acute rheumatic fever in the intermountain area of the United States. J Pediatr 1994; 124: 916.Google Scholar
25. Martins, TB, Veasy, LG, Hill, HR, Antibody responses to group. A streptococcal infections in acute rheumatic fever. Pediatr Infect Dis J 2006; 25: 832837.Google Scholar
26. Pilegga, GC, Ferriani, VP. Atypical arthritis in children with rheumatic fever. J Pediatr 2000; 76: 4954.Google Scholar
27. Khriesat, I, Najada, AH. Acute rheumatic fever without early carditis: an atypical clinical presentation. Eur J Pediatr 2003; 162: 868871.Google Scholar
28. Carepetis, JR, Currie, BJ. Rheumatic fever in high incidence population: the importance of monoarthritis and low grade fever. Arch Dis Child 2001; 85: 223227.Google Scholar
29. Harlan, GA, Tani, LY, Byington, CL. Rheumatic fever presenting as monoarticular arthritis. Pediatr Infect Dis J 2006; 25: 743746.Google Scholar
30. Demiroren, K, Yavuz, H, Cam, L, Oran, B, Karaaslan, S, Demiroren, S. Sydenham’s chorea: a clinical follow-up of 65 patients. J Child Neurol 2007; 22: 550554.CrossRefGoogle ScholarPubMed