Rheumatic fever: a multicenter study in the State of São Paulo

Silva, Carlos Henrique Martins da

doi:10.1590/s0041-87811999000300004

Cited by 40 publications

(38 citation statements)

References 9 publications

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“…Frequency of chorea (28%) was higher than that reported in the international literature, 2,4,6 with 15%-20% estimates, but was similar to the results reported in the Brazilian series, 11,14,22 nearly 30%. Chorea is characterized by involuntary movements of extremities, muscular hypotonia, dysartria, gait disturbance, and tics, as well as behavioral manifestations.…”

supporting

confidence: 85%

“…A systematic evaluation of patients care is important to defi ne further strategy for disease control and treatment. A systematic comparison of the present series with previously published series [11][12][13][14][15][16][17][18] is presented in the Table 2. Onset age was comparable.…”

Section: Discussionmentioning

confidence: 95%

“…In our series, only 58.2% had high antistreptolysin-O titres. A comparison with previous reported series described in Table 2, [11][12][13][14][15][16][17][18] in addition to a 24 comparing all Brazilian series published since the 1980's, indicated a wide variation, 48.7%-84.5%, from different studies in many parts of the country. Antistreptolysin-O rising titres in RF cases from our unit were previously examined, stressing the importance of serial determination over the fi rst two months.…”

mentioning

confidence: 76%

“…11,15 It was the second most frequent major sign, and mitral regurgitation was the most frequent valve involvement. During long term re-assessments, our survival analysis revealed 17.5% of carditis probability over fi ve years.…”

mentioning

confidence: 99%

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Apresentação e desfecho da febre reumática em uma série de casos

Carvalho¹,

Dalben²,

Corrente³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To assess the clinical characteristics and outcome of a rheumatic fever case-series from a referral hospital over the last 20 years. Patients and methods: Patients under the age of 18 years, diagnosed with rheumatic fever between 1986 and 2007 were retrospectively assessed to estimate the carditis and relapse rates, by use of descriptive and survival analysis. Results: Of 178 cases identifi ed, 134 were included. During the acute phase, 66.4% had polyarthritis, 56.8% had carditis, 28.6% had chorea, 1.5% had subcutaneous nodules, and 1.5% had erythema marginatum. The association of carditis and arthritis occurred in 40%. Carditis and chorea were more frequent among female gender. High antistreptolysin-O titres were found in 58.3%, and family history of rheumatic fever, in 14.5%. Mean follow-up was 6.8 years (1.1 to 16.9). Relapse was observed in 15%, hospital admissions in 27.6%, and follow-up discontinuation in 47.4% after a mean of 5.1 years. Carditis and relapse probabilities were 17.5% and 13.2%, respectively, fi ve years after the initial attack. Conclusion: The risk of carditis and relapse of rheumatic fever was higher within the fi rst fi ve years. Follow-up discontinuation was frequent, pointing to the need of measures to improve adherence to prophylaxis and follow-up.

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supporting

confidence: 85%

Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 76%

mentioning

confidence: 99%

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Apresentação e desfecho da febre reumática em uma série de casos

Carvalho¹,

Dalben²,

Corrente³

et al. 2012

Rev. Bras. Reumatol.

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“…Estudos recentes na área da Reumatologia Pediátrica têm abordado as características clínicas da fase aguda da febre reumática, enfatizando a sua alta prevalência em nosso meio, assim como as suas crescentes dificuldades diagnósticas 1,2 . Essas dificuldades decorrem da inexistên-cia de sinais patognomônicos e de exames laboratoriais específicos.…”

Section: Introductionunclassified

O perfil da antiestreptolisina O no diagnóstico da febre reumática aguda

Machado¹,

Ortiz²,

Martins³

et al. 2001

J. Pediatr. (Rio J.)

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ResumoObjetivo: estabelecer o perfil dos títulos de ASO, mediante o diagnóstico diferencial da FRA com outras afecções que também cursam com níveis elevados de ASO.Métodos: foram estudados 78 casos de FRA na apresentação e seguimento, 22 de coréia isolada, 45 de infecções orofaringeanas recorrentes (IOR) e 23 de artrites idiopáticas juvenis (AIJ), com início ou reativação recente. A determinação seqüencial de ASO (UI/ml) foi realizada por ensaio nefelométrico automatizado (Behring ® -Germany) nos períodos de 0-7 dias, 1-2 semanas, 2-4 semanas, 1-2 meses, 2-4 meses, 4-6 meses, 6-12 meses, 1-2 anos, 2-3 anos, 3-4 anos e 4-5 anos após o diagnóstico.Resultados: os títulos de ASO na fase aguda da FRA apresentaram elevação significante até o intervalo de 2-4 meses (p<0,0001), quando atingiram os níveis basais e permaneceram estáveis por 5 anos na vigência de profilaxia secundária com penicilina. Os valores de ASO na apresentação da FRA também foram mais elevados e com diferença significante quando comparados aos de coréia isolada, IOR e AIJ (p=0,0025). As variações etárias e o limite superior da normalidade (320 UI/ml) foram considerados para a comparação entre estes grupos, assim como para o cálculo da sensibilidade (73,3%) e da especificidade (57,6%) mediante o diagnóstico clínico de FRA. A especificidade e valor preditivo positivo do teste aumentaram com títulos crescentes, sendo mais alta com títulos >960 UI/ml.Conclusão: esta reavaliação do perfil da ASO indicou uma resposta exuberante na fase aguda da febre reumática indicou ainda que os seus níveis séricos podem diferenciá-la de outras afecções que também cursam com níveis elevados de ASO, como as infecções orofaringeanas recorrentes ou as artrites idiopáticas juvenis em atividade.J Pediatr (Rio J) 2001; 77 (2):105-11: artrite, febre reumática, antiestreptolisina, coréia. AbstractObjective: to determine ASO titer profile by establishing ARF differential diagnoses of other diseases with high levels of ASO antibodies.Methods: we investigated 78 patients with ARF at onset and follow-up, 22 with isolated chorea at onset, 45 with recurrent oropharyngeal tonsillitis, and 23 with recent flare of juvenile idiopathic arthritis. We tested ASO with automated particle-enhanced immunonephelometric assay (Behring ® -Germany). The ASO (IU/ ml) titers were assessed at the following time intervals: 0-7 days, 1-2 weeks, 2-4 weeks, 1-2 months, 2-4 months, 4-6 months, 6-12 months, 1-2 years, 2-3 years, 3-4 years, and 4-5 years after onset of ARF.Results: ASO titers in patients diagnosed with ARF had a significant increase up to the 2-4-month time interval (P<0.0001). Baseline levels were observed afterwards in patients under regular penicillin prophylaxis. The levels of ASO in ARF were also significantly higher than in patients with isolated chorea, recurrent oropharyngeal infections or juvenile idiopathic arthritis (P=0.0025), when age-matched samples of these groups were compared. The test's sensitivity was 73.3% and the specificity was 57.6%, and it was calculated taking into a...

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Taxonomy for systemic lupus erythematosus with onset before adulthood

Silva¹,

Avčin²,

Brunner³

2012

Arthritis Care & Research

161

116

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Objective To propose a common nomenclature to refer to individuals who fulfill the American College of Rheumatology Classification Criteria for systemic lupus erythematosus (SLE) during childhood or adolescence. Methods The medical literature was reviewed for studies conducted in the target population between 1960 and December of 2011 to obtain information about the terms used to refer to such children and adolescents. We reviewed the threshold ages used and disease features considered to discriminate these individuals from patients with onset of SLE during adulthood. Furthermore, the nomenclature used in other chronic diseases with onset during both childhood and adulthood was assessed. Results There was an astonishing variability in the age cut-offs used to define SLE-onset prior to adulthood, ranging from 14 to 21 years but most studies used 18 years of age. The principal synonyms in the medical literature were SLE without reference to the age at onset of disease, childhood-onset SLE, juvenile SLE, and pediatric (or paediatric) SLE. Conclusions Based on the definition of childhood, in analogy with other complex chronic disease commencing prior to adulthood, and given the current absence of definite genetic variations that discriminate adults from children, the term childhood-onset SLE is proposed when referring to individuals with onset of SLE prior to age 18 years.

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Rheumatic fever: a multicenter study in the State of São Paulo

Cited by 40 publications

References 9 publications

Apresentação e desfecho da febre reumática em uma série de casos

Apresentação e desfecho da febre reumática em uma série de casos

O perfil da antiestreptolisina O no diagnóstico da febre reumática aguda

Taxonomy for systemic lupus erythematosus with onset before adulthood

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