Acute rheumatic fever in south-east of Turkey: clinical features and epidemiological evaluation of the patients over the last 25 years

Erdem, Sevcan; Demir, Fadli; Ayana, Mustafa; Canan, Oğuz; Okuducu, Yankı Kaan; Arslan, Alev; Küçükosmanoğlu, Osman; Özbarlas, Nazan

doi:10.1017/s1047951120001596

Cited by 8 publications

(9 citation statements)

References 42 publications

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“…Gungor et al (11) reported a carditis rate of 82.2%. Again in Türkiye, in the largest series of 377 cases between 1993 and 2017, Erdem et al reported carditis as the most common major finding with 83.6% (17). In our study, the most common major finding in the group was carditis with a rate of 57.6%.…”

Section: Discussionsupporting

confidence: 54%

“…In studies covering the years 1982-2002 in Türkiye, the reported rate ranged from 4% to 17.9% (6,7,9,10). Erdem et al (17) reported this rate as 13.5% in their more recent study spanning the years 1993 to 2017. The rate of chorea in our study was 30.2%.…”

Section: Discussionmentioning

confidence: 96%

“…In our study, the most common major finding in the group was carditis with a rate of 57.6%. According to Karasalan et al (6), the mitral valve was the most commonly involved with 57%, Olguntürk et al (10) reported 98% mitral valve, 24.9% aortic valve involvement, and Erdem et al (17) reported 54.9% mitral valve, 34% mitral and aortic valve involvement. In our study, as in the literature, the mitral valve was the most commonly affected, accounting for 91% of all cases.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Pro-BNP in Children with Acute Rheumatic Fever

Erhan¹,

Olğar²

2022

JEURMEDS

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Objective: Acute rheumatic fever (ARF) is an autoimmune disorder associated with beta-hemolytic streptococcus infection (Group A). While acute carditis is the most significant manifestation of the disease, its involvement typically occurs on the skin, in the joints, heart, and central nervous system. Additionally, B-type natriuretic peptide (BNP) is an important myocardial function and prognosis marker. In this study, we examine the BNP levels in a children's cohort who were diagnosed with ARF clinical signs.Material and Methods: All patients with ARF were enrolled in Pediatric Cardiology. Thirty-three patients, aged 5-15 years (mean age 11.06 ± 2.18 years), with ARF, were examined, and their findings were compared to 41 children (mean age; 10.78 ± 2.87 years) who had previously developed ARF, as well as an additional 43 children (mean age; 9.53 ± 2.99 years) who had pain but no systemic and congenital heart disease. Furthermore, ARF patients were also assessed in subgroups such as carditis, chorea, and arthritis. Doppler echocardiographic examination was performed on all the patients. Pro-BNP levels were measured in patients with ARF after diagnosis and before treatment, and they were compared with patients who had previously had ARF and control groups upon admission. Pro-BNP levels were measured with a chemiluminescent assay. Comparisons were analyzed with variance analysis (ANOVA), post-hoc Tukey HSD, t-test analysis, and Pearson correlation. Results:The Pro-BNP values were 308.18 ± 402.65 pg/ml in patients with active ARF while Pro-BNP values were 84 ± 135.75 pg/ml, 64.82 ± 50.37 pg/ml in patients who previously had ARF and control group, respectively (p< 0.001). Pro-BNP values were higher in active carditis patients than in other subgroups. A positive correlation was found between Pro-BNP and ASO, CRP, ESR, and thrombocytes whereas there was a negative correlation between BNP and hemoglobin. Pro-BNP values decreased significantly with active carditis (101.12 ± 100.01 pg/ml) after treatment (p= 0.003). Conclusion:Unlike other cardiac enzymes, Pro-BNP revealed a statistical correlation with acute phase reactants, platelet count, and antistreptolysin O (ASO). Thus, this study proved that an increased Pro-BNP might be helpful for diagnosing patients with inflammation and cardiac involvement.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Pro-BNP in Children with Acute Rheumatic Fever

Erhan¹,

Olğar²

2022

JEURMEDS

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“…The noted seasonal variation in titer of ASOT which are most commonly observed in late winter and early spring is expected, but has no bearing on diagnosis of tonsillitis or otherwise (20). In the current study, in the recurrent tonsillitis group, ASOT significantly decreased after tonsillectomy than its value before it (212.1≤±24.3 IU/ml versus 274.8 ±22.3 IU/ml respectively, p value < 0.001).…”

Section: Discussioncontrasting

confidence: 50%

Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever

Eid

Mostafa

Tamim

et al. 2022

Pediatric Sciences Journal

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Background: Acute rheumatic fever and rheumatic heart disease are the significant nonsuppurative late sequelae of group A beta hemolytic streptococcal infection. Anti-streptolysin O titer (ASOT) is a streptococcal antibody test that is used for the diagnosis of infections and is particularly useful in the diagnosis of acute rheumatic fever. Aim of the work:To compare ASOT values in normal children to those with rheumatic fever and children with recurrent tonsillitis, and to evaluate its relationship with seasonal variations. Methods: A case-control study conducted on 300 children; 100 children with rheumatic fever, 100 with recurrent tonsillitis and 100 apparently healthy children as a control group. Children were subjected to history taking, echocardiography study and blood specimens for complete blood count, erythrocyte sedimentation rate, C reactive protein and ASOT were assessed using immunoturbidimetric assay tested by Cobas e501/502 (Roche). Human anti-streptolysin O antibodies (any type) agglutinate with latex particles coated with streptolysin O antigens. Results: Mean and SD of age in each group was 10.2±3 years for rheumatic fever group, 7.3± 3.8years for recurrent tonsillitis group and 5.4±2.4 years for control group. Rheumatic fever group included 49 males and 51 females, recurrent tonsillitis group included 58 males and 42 females, control group included 63 males and 37 females. ASOT ranged between 261-860 (mean± SD= 475.1±214.2), 210-813 (mean± SD= 257.6±56.4) and 65-820 (mean± SD= 158.8± 105.4) among those with rheumatic fever, tonsillitis and control group respectively (p=0.001). ASOT level between 400-800 IU/ml were common among patients with rheumatic fever and levels between 200-400 IU/ml were common with recurrent tonsillitis (p<0.001) with lack of diagnostic cut-off. Conclusion: ASOT levels are higher in rheumatic fever patients compared with recurrent tonsillitis and normal children. There is lack of diagnostic cut-off of ASOT, hence the value of ASOT is only within scoring system to avoid over or under diagnosis of acute rheumatic fever. An isolated high ASOT is not sufficient to diagnose or rule out acute rheumatic fever.

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“…While valvular pathologies can be completely cured after acute attack treatment or during the follow-up of patients, in some cases, the regurgitation continues to exist. Erdem et al 2 reported that 7.5% of the patients with valve regurgitation had complete resolution during follow-up. In our study, on the ECHO that was performed at the end of the follow-up, it was found that the rate of aortic regurtation went from 45.8% down to 42.2%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Children with Acute Rheumatic Fever: A Single-Center Experience

Güneş¹,

Akın²,

Türe³

et al. 2021

Turk Arch Pediatrics

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Objective: The epidemiological characteristics, risk factors, complications, recurrence status, clinical and laboratory features, and treatment methods of the patients who admitted to our Pediatric Cardiology Outpatient Clinic with a pre-diagnosis of acute rheumatic fever (ARF) were evaluated. Materials and Methods: The data of 166 patients who admitted with a pre-diagnosis of ARF and were diagnosed with ARF, and the data of 51 patients who were not diagnosed with ARF, were retrospectively analyzed. Results: The patients with ARF were between the ages of 5 and 18. Most of the patients with ARF attack admitted in December (15.6%), January (13.8%), and February (13.2%). The most common complaints of the patients diagnosed with ARF were isolated joint pain and/or swelling, at 50.6%. While 91.5% of the patients were diagnosed for the first time, 8.5% had ARF recurrence. It was seen that the most common major criterion was carditis (94.6%). The severity of valve regurgitation and the rates of monoarthritis were significantly higher in patients with recurrence ( P < .05). Non-compliance with prophylaxis was observed in 10 (71.4%) of 14 patients with recurrence, and in 43 (28.2%) of 152 patients without recurrence. Anti-streptolysin O was lower ( P = .021) and alanine transaminase (ALT) was higher ( P = .019) in the recurrence group. Conclusion: Our study showed that in patients with a pre-diagnosis of ARF, a differential diagnosis should be made with other diseases. Especially in patients with joint complaints as the only major symptom, a differential diagnosis should be made. ARF recurrence is associated with non-compliance with prophylaxis, and both the severity of valve regurgitation and monoarthritis rates are higher in patients who develop recurrence. Alanine aminotransferase is significantly higher in patients with ARF recurrence.

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Acute rheumatic fever in south-east of Turkey: clinical features and epidemiological evaluation of the patients over the last 25 years

Cited by 8 publications

References 42 publications

Evaluation of Pro-BNP in Children with Acute Rheumatic Fever

Evaluation of Pro-BNP in Children with Acute Rheumatic Fever

Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever

Evaluation of Children with Acute Rheumatic Fever: A Single-Center Experience

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