Rheumatic fever: the relationship between clinical manifestations and laboratory tests.
OBJECTIVE
To determine the relationship between the severity of clinical features of rheumatic fever (RF), and antistreptolysin O titre (ASOT) and/or erythrocyte sedimentation rate (ESR).


METHODS
Clinical and laboratory data from 102 children with RF who had been admitted at a university hospital in Tehran between 1992 and 2002 were reviewed retrospectively. In order to categorize the severity of clinical manifestations of disease, patients were divided into three groups. Those with arthritis alone were defined as group A, carditis with or without arthritis as group B and carditis (with or without arthritis) with congestive heart failure as group C.


RESULTS
Thirty-one cases were enrolled in group A, 39 in group B, and 32 in group C. We didn't find a significant relationship between the severity of clinical presentation of disease and ASOT (P = 0.89) and ESR (P = 0.24). Seventy-two patients presented with first attack and 30 had recurrences. The frequency of congestive heart failure (CHF) in first attacks was 31.2%vs 68.8% in recurrences (P < 0.0001). No Significant relationship was found between the number of involved valves and ASOT (P = 0.4) or ESR (P = 0.8).


CONCLUSIONS
Variable clinical presentation of disease and increasing intensity of cardiac involvement is not related to the ASOT or ESR levels.
Roodpeyma
S
S
Department of Pediatrics, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. Shahla_1328@yahoo.com <Shahla_1328@yahoo.com>
Kamali
Z
Z
Zare
R
R
D000328:Adult; D000989:Antistreptolysin / Q000097:blood / Q000276:immunology*; D001168:Arthritis / Q000150:complications; D001799:Blood Sedimentation; D002648:Child; D019411:Clinical Laboratory Techniques; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008499:Medical Records; D009205:Myocarditis / Q000150:complications; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000145:classification* / Q000150:complications / Q000503:physiopathology; D012720:Severity of Illness Index
D000989:Antistreptolysin