title: [Is rheumatic fever a more severe disease in pre-school children?].
abstract: 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.
authors.affiliation: 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.
authors.forename: Luciana T S P
authors.initials: LT
authors.lastname: Paulo
authors.forename: Maria Teresa R A
authors.initials: MT
authors.lastname: Terreri
authors.forename: Cássia Maria P
authors.initials: CM
authors.lastname: Barbosa
authors.forename: Claudio Arnaldo
authors.initials: CA
authors.lastname: Len
authors.forename: Maria Odete E
authors.initials: MO
authors.lastname: Hilário
mesh_terms: 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