The Turkish Journal of Pediatrics 2005; 47: 120-124 Original Childhood acute rheumatic fever in Ankara, Turkey

Patients with acute rheumatic fever (ARF) admitted to a tertiary hospital in Ankara between January 1999 and July 2002 were studied cross-sectionally to verify the clinical profile and were followed during the acute period. All patients were investigated for throat culture, streptococcal serologic study, C-reactive protein, and erythrocyte sedimentation rate, and telecardiograms, electrocardiograms and echocardiographic study were done. During the study period, 129 attacks of ARF were observed: 118 were initial attacks and 11 were recurrences. Age on admission was 11.2±2.73 years (mean±SD, range: 6-21 years). Polyarthritis alone was present in 42 cases (33%), carditis alone in 33 (25%), combined carditis and polyarthritis in 36 (28%), combined carditis and chorea in 15 (12%) and chorea alone in 3 (2%). Nineteen (14%) patients with isolated arthritis and pure chorea had silent mitral and/or aortic regurgitation. Carditis was a dominant presenting manifestation, but appeared to be mild or moderate. The present study indicates that ARF is still a significant problem in Turkey. The observation that 8.5 % of the attacks were recurrent reaffirms the need for more effective secondary prevention programs. Key words: acute rheumatic fever, rheumatic heart disease, children. Acute rheumatic fever (ARF) is the most serious nonsupurative sequela of group A streptococcus infection. The incidence of ARF has declined in industrialized countries since the 1950’s and now has an annual incidence of around 0.5 cases per 100,000 children of school age1. In developing countries, however, it remains an endemic disease with annual incidences ranging from 100 to 200 per 100,000 school aged children, and is a major cause of cardiovascular mortality1. Turkey is one of the countries in which the incidence of ARF and the prevalence of rheumatic heart disease are still high2,3. We studied cross-sectionally 129 children see