[Is rheumatic fever a more severe disease in pre-school children?].
OBJECTIVE
To assess the frequency and characteristics of clinical manifestations of rheumatic fever in children and adolescents according to the age of onset of the disease.


METHODS
We evaluated in a retrospective cohort study the clinical and demographic data of rheumatic fever patients followed at our service for at least 6 months and who attended 2 or more visits.


RESULTS
The charts of 202 children and adolescents with rheumatic fever were evaluated and divided into 3 groups according to the age of the first episode of rheumatic fever: group 1- patients under 5 years old (8 [4%]), group 2- patients between 5 and 9 years (84 [42%]) and group 3 patients with 10 years old or older (110 [54%]). The mean follow-up was 4.1 years. Carditis occurred in 24%, 42% and 50%; arthritis in 75%, 71% and 69% and chorea in 25%, 37% and 34% in groups 1, 2 and 3 respectively. There was no statistical difference between the groups in relation to the frequency of such events and of severe carditis, however we observed lower numeric frequency of carditis and Sydenham chorea in children younger than 5 years.


CONCLUSIONS
Rheumatic fever, although less frequent, can be found in children under 5 years with no significant difference in relation to the frequency or severity of clinical manifestations.
Paulo
Luciana T S P
LT
Setor de Reumatologia Pediátrica, Disciplina de Alergia, Imunologia clínica e Reumatologia do Departamento de Pediatria da Universidade Federal de São Paulo - Escola Paulista de Medicina.
Terreri
Maria Teresa R A
MT
Barbosa
Cássia Maria P
CM
Len
Claudio Arnaldo
CA
Hilário
Maria Odete E
MO
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000453:epidemiology*; D012720:Severity of Illness Index