Evaluation of the clinical, laboratory characteristics, recurrent situations and additional diseases of the patients who were followed with the diagnosis of acute rheumatism fever i̇n the pediatric cardiology clinic

It was aimed to retrospectively evaluate the clinical and laboratory features, recurrence and comorbidities of patients who were followed up with a diagnosis of acute rheumatic fever between 2012 and 2019 in the Pediatric Cardiology Clinic of our hospital. The data of 95 patients who were followed up with the diagnosis of acute rheumatic fever between January 2012 and December 2019 in Fırat University Medical Faculty Pediatric Cardiology Clinic were retrospectively analyzed and evaluated. 95 patients, 43 (%45.3) girls and 52 (%54.7) boys, who were admitted between the specified dates and diagnosed with acute rheumatic fever, were included in our study. The ages of the patients ranged from 2.9 years to 16.11 years, with a mean of 11.4 ± 2.74 years. The cases were grouped according to age groups as 0-5, 5-9, 9-15 and > 15 years old. The largest group in the grouping was between 9 and 15 years of age with 69 patients, making up %72.6 of all cases. Considering the admission seasons of our patients, it was found that the disease was more common in winter (%34.8) and spring (%29.5) seasons. When the distribution of the disease by months was examined, it was found that the cases were most frequently admitted in December (%22.1) and November (%14.7). When the complaints of the patients applying to the hospital were examined, it was seen that they most frequently applied with joint complaints. Joint complaints were the first complaints in 77 (%81.1) of the patients. When the patients were evaluated according to major Jones criteria, %82.1 had carditis, %72.6 had arthritis (%47.3 had polyarthritis, %11.6 had monoarthritis, %13.7 had polyarthralgia), %10.5 had chorea, %2,1 had erythema marginatum. No patient was found with a subcutaneous nodule. Among the minor Jones criteria, fever was found to be %64. 2, prolonged PR interval on ECG %20, monoarthralgia % 5.3, and CRP as acute phase reactant was found to be high (≥ 3 mg / dL) in %89.5 patients, while sedimentation was found to be high in %75.8 patients (≥ 30 mm / h) has been found. The CRP values vary between 0 and 207, with an average of 52.7 ± 59.32, with sedimentation values varying between 1- 121, with an average of 55.69 ± 29.6. When the patients were evaluated according to the coexistence of major Jones criteria, the most common carditis- arthritis combination was seen in 52 (%54.7) patients. When valvular involvement was examined in the echocardiographic findings of patients with carditis, %91 of mitral valve involvement and %32 of aortic valve involvement were observed. A significant correlation was found between the major Jones criteria and age and gender only in terms of chorea (p = 0.003; p<0.05). Considering the incidence of minor symptoms among age groups, the incidence of monoarthralgia in the 0-5 age group was found to be significantly higher than the others (p = 0.22; p<0.05). Recurrence was detected in 3 of our patients and arthritis-carditis association was observed in all patients with recurrence. In our study, carditis was the most common major finding in patients diagnosed with acute rheumatic fever. The most common minor finding was acute phase reactant positivity. When the major criteria combinations were evaluated, arthritis-carditis combination was the most common. When the frequency of valve involvement was examined, mitral valve involvement was the most common. Among the major criteria, Korea was significantly more common in female gender. Among the minor criteria, monoarthralgia was found to be significantly more common in the 0-5 age group.