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Parameters indicative of persistence of valvular pathology at initial diagnosis in acute rheumatic carditis: the role of albumin and CD19 expression / Parâmetros indicativos de persistência de patologia valvular no diagnóstico inicial de cardite reumática aguda: o papel da albumina e da expressão de CD19
Oner, Taliha; Ozdemir, Rahmi; Genc, Dildar Bahar; Kucuk, Mehmet; Karadeniz, Cem; Demirpence, Savas; Yilmazer, Murat Muhtar; Mese, Timur; Tavli, Vedide; Genel, Ferah.
  • Oner, Taliha; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Ozdemir, Rahmi; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Genc, Dildar Bahar; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Kucuk, Mehmet; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Karadeniz, Cem; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Demirpence, Savas; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Yilmazer, Murat Muhtar; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Mese, Timur; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Tavli, Vedide; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
  • Genel, Ferah; Izmir Dr. Behcet Uz Children's Hospital. Pediatric Cardiology. Izmir. TR
J. pediatr. (Rio J.) ; 92(6): 581-587, Nov.-Dec. 2016. tab
Article in English | LILACS | ID: biblio-829128
ABSTRACT
Abstract

Objective:

The aim of this study is to define the predictors of chronic carditis in patients with acute rheumatic carditis (ARC).

Methods:

Patients diagnosed with ARC between May 2010 and May 2011 were included in the study. Echocardiography, electrocardiography, lymphocyte subset analysis, acute phase reactants, plasma albumin levels, and antistreptolysin-O (ASO) tests were performed at initial presentation. The echocardiographic assessments were repeated at the sixth month of follow-up. The patients were divided into two groups according to persistence of valvular pathology at 6th month as Group 1 and Group 2, and all clinical and laboratory parameters at admission were compared between two groups of valvular involvement.

Results:

During the one-year study period, 22 patients had valvular disease. Seventeen (77.2%) patients showed regression in valvular pathology. An initial mild regurgitation disappeared in eight patients (36.3%). Among seven (31.8%) patients with moderate regurgitation initially, the regurgitation disappeared in three, and four patients improved to mild regurgitation. Two patients with a severe regurgitation initially improved to moderate regurgitation (9.1%). In five (22.8%) patients, the grade of regurgitation [moderate regurgitation in one (4.6%), and severe regurgitation in 4 (18.2%)] remained unchanged. The albumin level was significantly lower at diagnosis in Group 2 (2.6 ± 0.48 g/dL). Lymphocyte subset analysis showed a significant decrease in the CD8 percentage and a significant increase in CD19 percentage at diagnosis in Group 2 compared to Group 1.

Conclusion:

The blood albumin level and the percentage of CD8 and CD19 (+) lymphocytes at diagnosis may help to predict chronic valvular disease risk in patients with acute rheumatic carditis.
RESUMO
Resumo

Objetivo:

Definir os preditores da cardite crônica em pacientes com cardite reumática aguda (CRA).

Métodos:

Os pacientes diagnosticados com CRA entre maio de 2010 e maio de 2011 foram incluídos no estudo. Foram feitos os testes de ecocardiografia, eletrocardiograma, uma análise do subgrupo de linfócitos, provas de fase aguda, níveis de albumina plasmática, antiestreptolisina-O (ASO) na manifestação inicial. As avaliações ecocardiográficas foram repetidas no 6º mês de acompanhamento. Os pacientes foram divididos em dois grupos de acordo com a persistência da patologia valvular no 6º mês como Grupo 1 e Grupo 2 e todos os parâmetros clínicos e laboratoriais na internação foram comparados entre dois grupos de comprometimento valvular.

Resultados:

Durante o período do estudo de um ano, 22 pacientes apresentaram doença valvular; 17 (77,2%) apresentaram regressão da patologia valvular. Houve desaparecimento de regurgitação moderada inicial em oito pacientes (36,3%). Entre sete (31,8%) pacientes com regurgitação moderada inicialmente, a regurgitação desapareceu em três e quatro apresentaram melhoria para regurgitação leve. Dois pacientes com regurgitação grave inicialmente apresentaram melhoria para regurgitação moderada (9,1%). Em cinco (22,8%) pacientes o grau de regurgitação (regurgitação moderada em um [4,6%] e regurgitação grave em quatro [18,2]) continuou inalterado. O nível de albumina foi significativamente menor no diagnóstico no Grupo 2 (2,6 ± 0,48 gr/dL). A análise do subgrupo de linfócitos mostrou uma redução significativa no percentual de CD8 e um aumento significativo no percentual de CD19 no Grupo 2 em comparação com o Grupo 1.

Conclusão:

O nível de albumina no sangue e o percentual de linfócitos CD8 e CD19 (+) no diagnóstico podem ajudar a prever risco de doença valvular crônica em pacientes com cardite reumática aguda.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Aortic Valve Insufficiency / Rheumatic Heart Disease / Serum Albumin / Antigens, CD19 / Mitral Valve Insufficiency / Myocarditis Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Child / Female / Humans / Male Language: English Journal: J. pediatr. (Rio J.) Journal subject: Pediatrics Year: 2016 Type: Article Affiliation country: Turkey Institution/Affiliation country: Izmir Dr. Behcet Uz Children's Hospital/TR

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Full text: Available Index: LILACS (Americas) Main subject: Aortic Valve Insufficiency / Rheumatic Heart Disease / Serum Albumin / Antigens, CD19 / Mitral Valve Insufficiency / Myocarditis Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Child / Female / Humans / Male Language: English Journal: J. pediatr. (Rio J.) Journal subject: Pediatrics Year: 2016 Type: Article Affiliation country: Turkey Institution/Affiliation country: Izmir Dr. Behcet Uz Children's Hospital/TR