Study population
Twenty-nine patients (mean age 12.3±3.2 years, range 6-18 years; 14
male/15 female) diagnosed with acute rheumatic fever from January 2016
to January 2017 were prospectively enrolled in this study. Two patients
who were diagnosed with juvenile idiopathic arthritis and systemic lupus
erythematosus upon enrollment in the study were excluded afterward. The
study cohort was divided into two subgroups on the basis of valve
involvement [9]. The moderate/severe carditis group consisted of 12
patients with moderate/severe valvular involvement. No/mild carditis
group consisted of 15 patients with mild valvular involvement or no
valvular involvement. All measures were compared with values of 27
healthy children of similar sex and age (mean age 11.7±3.1 years, range
7-17 years; 16 male/11 female, p=0.781 for age, p=0.722 for sex).
The patients were included in the study according to previously defined
revised Jones criteria for acute rheumatic fever [10]. Patients with
recurrent RHD were not included in the study. Erythrocyte sedimentation
rate and C-Reactive protein values were measured in all patients before
and after the treatment. After a single dose of benzathine penicillin
patients who were diagnosed with moderate/severe carditis were treated
with corticosteroids for 4-6 weeks and after steroids, they were
administered with non-steroid anti-inflammatory drugs (NSAID) for an
additional 2-4 weeks. Patients who were diagnosed as no/mild carditis
were treated with NSAID for 2-6 weeks after a single dose of benzathine
penicillin. Both the patients and the controls underwent a standard
transthoracic echocardiographic examination and STE.
The study complied with the Declaration of Helsinki and the Clinical
Research Ethical Committee approved the study (decree no: 2017-027). The
families of the patients provided their informed consent.