Rheumatic fever: a multicenter study in the State of São Paulo
DOI:
https://doi.org/10.1590/S0041-87811999000300004Keywords:
Rheumatic fe, Epidemiol, Cardic dise, Department of Rheumatol, Pediatrics Society of São PaAbstract
Rheumatic fever is still the most commonly seen rheumatic disease in Brazilian pediatric rheumatology clinics. It remains a significant health problem since subsequent cardiac sequelae represent one of the most important causes of chronic heart disease in children. We reviewed the clinical manifestations of rheumatic fever in 786 patients, followed at seven pediatric rheumatology clinics in the state of São Paulo, Brazil. All patients were diagnosed according to revised Jones' criteria. Regarding major criteria, 396 (50.4%) children exhibited carditis, 453 (57.6%) polyarthritis, 274 (34.8%) chorea, 13 (1.6%) erythema marginatum, and 12 (1.5%) subcutaneous nodules. Valvular lesions documented by echocardiography in the absence of accompanying auscultatory findings were found in 144 (18.3%) patients. Migratory polyarthritis was observed in 290 (64.0%) patients with articular involvement. Documented previous streptococcal infection assessed by serum antistreptolysin (ASO) titers occurred in 531 (67.5%) patients. Even though prophylaxis with benzathine penicillin was recommended to all patients, recurrent attacks were observed in 147 (18.7%). We emphasize the high frequency of chorea, silent carditis and recurrences in our series as well as the variable clinical presentation of arthritis in rheumatic fever. Multicenter studies should be encouraged to improve our understanding of the clinical features of rheumatic diseases in children and adolescents.Downloads
Published
1999-06-01
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Section
Original Articles
How to Cite
Silva, C. H. M. da. (1999). Rheumatic fever: a multicenter study in the State of São Paulo . Revista Do Hospital Das Clínicas, 54(3), 85-90. https://doi.org/10.1590/S0041-87811999000300004