Declining Severity of First Attack of Rheumatic Fever

Mayer, Florence E.; Doyle, Eugenie F.; Herrera, Lee; Brownell, Katharine Dodge

doi:10.1001/archpedi.1963.02080040148004

Cited by 15 publications

(3 citation statements)

References 10 publications

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“…[10][11][12] Thompkins and colleagues also demonstrated that if secondary prophylaxis is reliably followed, approximately 70% of individuals developing the murmur of mitral incompetence at the time of an acute attack of rheumatic fever will lose that murmur over the next 5 years. 13 The incidence of carditis in this series was high and only 30% of cases with mitral incompetence at onset had a decrease in severity or had lost the murmur on follow-up.…”

Section: Discussionmentioning

confidence: 99%

The changing incidence of juvenile mitral stenosis and natural history of rheumatic mitral valvulitis in Al Baha, Saudi Arabia

Andy

Soomro²

2001

Annals of Tropical Paediatrics

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This study aimed to evaluate the impact of improved socio-economic conditions and health care on chronic mitral valve complications of rheumatic heart disease in Al Baha in the Kingdom of Saudi Arabia. Altogether, 190 cases of acute rheumatic fever (ARF) seen between 1982 and 1996 and 146 cases of symptomatic mitral stenosis seen between 1984 and 1996 were analysed. 2-D/Doppler echocardiography was used to evaluate the severity and progression of mitral regurgitation (MR)/mitral stenosis (MS). Of 90 cases of ARF who presented initially with MR, the murmur remained unchanged in 40%, increased in 30% and had decreased or disappeared in 30%. In cases with recurrence of ARF, mitral incompetence deteriorated in 16 of 26 cases (61.5%) and remained stable in ten (38%). Severe MS developed during follow-up in three cases of ARF, all aged less than 20 years. Seven of 50 cases (14%) of severe MS studied were aged 20 years or less. The 43% (25 of 58 cases) of severe cases of MS aged 20 years or less reported from King Faisal Hospital, Riyadh in 1981 compared with 14% of severe cases aged 20 years or less in this study indicates a significant slowing down of the rate of progression of MS following an attack of ARF in this region. Among individuals with MR during an ARF attack who reliably take their antibiotic prophylaxis, 70% will lose that murmur within 5 years of follow-up. In this series, only 30% showed a decrease or loss of MR and this probably reflects the degree of non-compliance with secondary antibiotic prophylaxis in our cases. The rate of default from antibiotic prophylaxis was 32.6%.

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Section: Discussionmentioning

confidence: 99%

The changing incidence of juvenile mitral stenosis and natural history of rheumatic mitral valvulitis in Al Baha, Saudi Arabia

Andy

Soomro²

2001

Annals of Tropical Paediatrics

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“…However, this does not apply to our population, since in Israel during the last two decades the rheumatogenic types have remained constant and relatively high (18%-33% of all positive throat cultures; A. Beck, personal communication). Some observers have reported a declining incidence of carditis [3,10,12,14], suggesting that RF is becoming a milder disease. However, Denny [7] questioned this last finding based on data derived from various countries in different areas of the world [1,11,18].…”

Section: Discussionmentioning

confidence: 99%

Acute rheumatic fever in the young: changing prevalence and pattern

et al. 1988

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Acute rheumatic fever (ARF) is rare in young people. A group of 28 patients is described who were hospitalized during the years 1960-1984. Patients were divided into two groups: children who were admitted between 1960 and 1966 and those admitted between 1966 and 1984. The annual incidence of ARF declined from 1.17 to 0.44 cases per 10,000 population at risk. The incidence of arthritis declined in parallel to the decrease in number of children presenting with ARF, whereas the incidence of carditis remained the same.

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“…The incidence ot carditi5 m d the mortality during the acute attack may also have decreased (812,816). I n a hosPit"l-as~ernb1ed population rheumatic fever patients with arthralgia had carditis more frequently and more \e\ erely than patients with polyarthritiy (364).…”

Section: Natural Historymentioning

confidence: 99%

Review of American and English literature for the years 1963 and 1964 (Seventeenth Rheumatism Review)

1966

Arthritis & Rheumatism

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Declining Severity of First Attack of Rheumatic Fever

Cited by 15 publications

References 10 publications

The changing incidence of juvenile mitral stenosis and natural history of rheumatic mitral valvulitis in Al Baha, Saudi Arabia

The changing incidence of juvenile mitral stenosis and natural history of rheumatic mitral valvulitis in Al Baha, Saudi Arabia

Acute rheumatic fever in the young: changing prevalence and pattern

Review of American and English literature for the years 1963 and 1964 (Seventeenth Rheumatism Review)

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