ABSTRACT
OBJECTIVES: 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). CONCLUSION: Variable clinical presentation of disease and increasing intensity of cardiac involvement is not related to the ASOT or ESR levels.
Subject(s)
Antistreptolysin/immunology , Rheumatic Fever/classification , Adult , Antistreptolysin/blood , Arthritis/complications , Blood Sedimentation , Child , Clinical Laboratory Techniques , Female , Heart Failure/complications , Humans , Male , Medical Records , Myocarditis/complications , Retrospective Studies , Rheumatic Fever/complications , Rheumatic Fever/physiopathology , Severity of Illness IndexSubject(s)
Cardiovascular Diseases/prevention & control , Chelation Therapy/methods , beta-Thalassemia/therapy , Adolescent , Cardiovascular Diseases/etiology , Chelating Agents/therapeutic use , Child , Child, Preschool , Deferoxamine/therapeutic use , Female , Humans , Male , beta-Thalassemia/complicationsABSTRACT
Twenty children, aged 6 months to 13 years, with acute pericarditis admitted between 1987 and 1997 to a university hospital were analyzed retrospectively for their etiology, presentation, management, and prognosis. The most common types of pericarditis were purulent (40%), collagen vascular disease (30%), viral (20%), and neoplastic disease (10%). Most children presented with chest pain, fever, and tachypnea, but cardiac tamponade was not seen in any children. Staphylococcus aureus was the most frequent causative organism of purulent pericarditis and septic arthritis was the most common concurrent infection in the patients. Surgical drainage was performed for 11 cases, 9 underwent subxiphoid pericardial window, and 2 underwent thoracotomy. There was no constrictive pericarditis or reaccumulation of fluid after surgery. Two children died, one of staphylococcal septicemia and the other had a malignant mediastinal tumor. The remaining 18 made a complete recovery. We conclude that subxiphoid pericardial drainage is a simple, safe, and quick procedure and can be done easily in general hospitals by pediatric surgeons. The expensive facilities of cardiac surgeries are not needed.
Subject(s)
Pericarditis , Acute Disease , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Pericardial Effusion/chemistry , Pericarditis/diagnosis , Pericarditis/etiology , Pericarditis/therapy , Prognosis , Retrospective StudiesABSTRACT
The authors describe an 11-year-old girl with systemic lupus erythematosus (SLE) who developed simultaneous bilateral acute optic neuritis. Severe initial visual loss followed by permanent visual deficit occurred in both eyes despite therapeutic intervention. Recurrence of optic neuritis in one eye caused the vision to deteriorate further. The most probable pathogenesis is occlusive vasculitis involving the small arterioles of the optic nerves.