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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: [email protected]
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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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References

Watkins, DA, Johnson, CO, Colquhoun, SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med 2017; 377: 713–722. DOI 10.1056/NEJMoa1603693.CrossRefGoogle ScholarPubMed
Gewitz, MH, Baltimore, RS, Tani, LY, et al. American heart association committee on rheumatic fever, endocarditis and kawasaki disease of the council on cardiovascular disease in the young. Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of doppler echocardiography. Circulation 2015; 131: 1806–1818. DOI 10.1161/CIR.0000000000000205.CrossRefGoogle Scholar
Eroğlu, AG. Update on diagnosis of acute rheumatic fever: 2015 Jones criteria. Turk Pediatri Ars 2016; 51: 1–7.CrossRefGoogle ScholarPubMed
Orün, 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: 361–368. DOI 10.1007/s00431-011-1555-x.CrossRefGoogle ScholarPubMed
Otto, CM. Valvular regurgitation: diagnosis quantitation and clinical approach. In: Otto, CM (eds). Textbook of Clinical Echocardiography, 2nd. WB Saunders, Philadelphia, 2000, p. 265–300.Google Scholar
Helmcke, F, Nanda, NC, Hsiung, MC, et al. Color doppler assessment of mitral regurgitation with orthogonal planes. Circulation 1987; 75: 175–183. DOI 10.1161/01.CIR.75.1.175.CrossRefGoogle ScholarPubMed
Perry, GJ, Helmcke, F, Nanda, NC, Byard, C, Soto, B. Evaluation of aortic insufficiency by doppler color flow mapping. J Am Coll Cardiol 1987; 9: 952–959. DOI 10.1016/S0735-1097(87)80254-1.CrossRefGoogle ScholarPubMed
Dajani, AS, Ayooub, E, Bierman, FZ, et al. Special writing group of the committee on rheumatic fever, endocarditis and kawasaki disease of the council on cardiovascular disease in the young the american heart association. guidelines for the diagnosis of rheumatic fever. Update Jones Criteria 1992; 268: 2069–2073.Google Scholar
Khaled, A, Yosef, U. Acute rheumatic fever and poststreptococcal reactive arthritis. In: Petty, RE, Laxer, R, Lindsley, C, Wedderburn, L (eds). Textbook of Pediatric Rheumatology, 7th. Elsevier, Inc, 2016, p. 571–585.Google Scholar
Vinker, S, Zohar, E, Hoffman, R, Elhayany, A. Incidence and clinical manifestations of rheumatic fever: a 6 year community-based survey. Isr Med Assoc J 2010; 12: 78–81.Google ScholarPubMed
Kumar, R, Sharma, YP, Thakur, JS, et al. Streptococcal pharyngitis, rheumatic fever and rheumatic heart disease: eight-year prospective surveillance in Rupnagar district of Punjab. India Natl Med J India 2014; 27: 70–75.Google ScholarPubMed
Kocevar, U, Toplak, N, Kosmac, B, et al. Acute rheumatic fever outbreak in southern central european country. Eur J Pediatr 2017; 176: 23–29. DOI 10.1007/s00431-016-2801-z.CrossRefGoogle ScholarPubMed
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: 832–836.CrossRefGoogle Scholar
Milne, RJ, Lennon, DR, Stewart, JM, Vander Hoorn, S, Scuffham, PA. Incidence of acute rheumatic fever in New Zeland children and youth. J Paediatr Child Health 2012; 48: 685–691.CrossRefGoogle Scholar
Lawrence, JG, Carapetis, JR, Griffiths, K, Edwards, K, Condon, JR. Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010. Circulation 2013; 128: 492–501 .CrossRefGoogle ScholarPubMed
Karthikeyan, G, Guilherme, L. Acute rheumatic fever. Lancet 2018; 392: 161–174.CrossRefGoogle ScholarPubMed
Karademir, S, Demirçeken, F, Atalay, S, Demircin, G, Sipahi, T, Teziç, T. Acute rheumatic fever in children in the Ankara area in 1990-1992 and comparison with a previous study in 1980-1989. Acta Paediatr 1994; 83: 862–865.CrossRefGoogle ScholarPubMed
Özer, S, Olgu Hallıoğlu, O, Özkutlu, S, Çeliker, A, Alehan, D, Karagöz, T. Childhood acute rheumatic fever in Ankara. Turkey Turk J Pediatr 2005; 47: 120–124.Google ScholarPubMed
Bostan, ÖM, Çil, E. Bursa İlindeki Çocuklarda akut romatizmal ateşin değerlendirilmesi. T Klin J Cardiol 2001; 14: 276–281.Google Scholar
Çağatay, D, Yıldız, F, Temel, Ö., Arslan, Ö., İnalhan, M. Akut romatizmal ateş: klinik bir değerlendirme. J Child 2010; 10: 183–189. DOI 10.5222/j.child.2010.183.Google Scholar
Pirinççioğlu, AG, Alyan, Ö., Kanğın, , et al. Akut romatizmal ateşli çocuklarda klinik ve laboratuvar bulguların geriye dönük olarak incelenmesi: reaktivasyon ve koruyucu tedaviye uyumunun araştırılması. Turk Kardiyol Dern Ars 2012; 40: 427–435. DOI 10.5505/tkda.2012.87405.Google Scholar
Karaaslan, S, Oran, B, Reisli, I, Erkul, I. Acute rheumatic fever in Konya. Turkey Pediatr Int 2000; 42: 71–75. DOI 10.1046/j.1442-200x.2000.01180.x.CrossRefGoogle ScholarPubMed
World Health Organization. Rheumatic fever and rheumatic heart disease: report of a WHO expert consultation, 29 October-1 November 2001. Geneva, 2004. Available at: https://apps.who.int/iris/handle/10665/42898, WHO technical report series 923.Google Scholar
Reményi, B, Wilson, N, Steer, A, et al. World heart federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline. Nat Rev Cardiol 2012; 9: 297–309. DOI 10.1038/nrcardio.2012.7.CrossRefGoogle ScholarPubMed
Tubridy-Clark, M, Carapetis, JR. Subclinical carditis in rheumatic fever: a systematic review. Int J Cardiol 2007; 119: 54–58. DOI 10.1016/j.ijcard.2006.07.046.CrossRefGoogle ScholarPubMed
(ARF/RHD writing group), RHDAustralia. The 2020 australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (3rd edition),. 2020. (viewed June 2021). Available at: https://www.rhdaustralia.org.au/arf-rhd-guideline.Google Scholar