Retrospectively clinical and epidemiological evaluation of patients with acute rheumatic fever who attended to Pediatric Cardiology Clinic of the Cukurova University between january 2000 and january 2013

Objective: The aim of this study was to evaluate retrospectively clinical and epidemiological features of rheumatic fever and rheumatic heart disease using last twelwe year's data of our hospital, to investigate incidence and seasonal prevalance, to detect changes over time in clinical and epidemiological features by comparing with other studies, and finally to illuminate the clinicians. Materials and Methods: The medical records of 190 patients with rheumatic fever (first attack or recurrence), rheumatic heart disease or previous rheumatic fever who admitted to Pediatric Cardiology Department of the Cukurova University between January 2000 and January 2013 were analyzed retrospectively. Findings: The age of patients at presentation ranged between 6 and 17 years (mean age 10,75±2,6). Fifty-seven of patients (% 46) were female; 66 patients (% 54) were male. Thirty-seven per cent of the patients with acute rheumatic fever were admitted in winter, % 22 in spring, % 27 in summer and % 14 in autumn. Sixty-two per cent of patients were living within the borders of Adana, % 38 were coming from out of province. While acute reumatic fever rate in patients who attended to our Pediatric Cardiology clinic was % 1,08 in 2000, it was % 0,03 in 2012. Latent period ranged 7-28 days (mean 17±5,9 days). Eighty-six per cent of the patients had carditis, % 79 had polyarthritis, % 18 had chorea, % 1,6 had subcutaneous nodules. The most common complaint at presentation was arthralgia (% 76). Eighty-six per cent of 123 patients with acute attack had carditis. Forty-eight of 106 patients with carditis (% 45,2) had mild carditis, 20 of (% 18,8) had moderate carditis, 38 of (% 35,8) had severe carditis. No significant correlation found between the severity of carditis and age, sex, residing or acute phase reactants. The most commonly affected joints were knee (% 73) and ankle (% 66). The most commonly affected valve was mitral valve (%95), and then aortic valve (%42). Recurrence observed in % 36,3 of patients who didn't take prophylaxis regularly. The valve lesion healed completely in % 20,4 of carditis patients coming with first attack; and % 13 of with recurrences. Rebound was seen % 4,7 of patients with carditis, and recurrence in % 7,5; congestive heart failure in % 35,8; pericardial effusion in % 5,6; dysrhythmia in % 0,9 and silent carditis in % 19,9. Eight patients underwent surgery. Conclusion: Although the incidence of acute rheumatic fever has decreased, it still continues to be an important disease can lead to serious morbidity and mortality in our country. By country-wide formation of large-scale data collection systems and obligatory notification systems, in the future, incidence, morbidity and mortality of acute rheumatic fever will be determined more precisely and although genetic factors can not be changed, changes in environmental factors and health policy will decrease the frequency of the disease and its complications. Anahtar Kelimeler: Acute rheumatic fever (ARF), rheumatic heart disease (RHD), clinical, epidemiological, incidence, Cukurova University.