Evaluation of cardiac involvement in children with Sydenham’s chorea during hospitalization and mid-term follow-up

Abstract

Rheumatic fever is a non-purulent and acute inflammatory com-plication caused by group A streptococcus infection, which is the cause of purulent pharyngitis. This infection may cause a combi-nation of arthritis, carditis, subcutaneous nodules, erythema marginatum, and chorea. Sydenham's chorea is often seen as an isolated chorea, but it may also occur with carditis. The purpose of this research is to investigate the rate of cardiac complications in children admitted to Tabriz Children's Hospital, with the de-scription of rheumatic fever and Sydenham's disease and follow-up in the medium term of 6 months and 1 year. Materials and Methods All children aged 5-16 hospitalized in Shahid Madani Children’s Hospital Tabriz with initial diagnosis of acute rheumatic fever and Sydenham chorea were included for cardiac assessment and 6 months and one year period fallow up between 1380 to 1400. All children aged 5-16 years hospitalized with initial diagnosis of acute rheumatic fever who met the revised Jones criteria, were included for initial and 6-month and 1-year cardiac involvemrnt follow-up, at Shahid Madani Children's Educational-Therapeutic Center in Tabriz, during the years 1388 to 1400. Clinical exami-nations and echocardiography and determinative tests were per-formed for each patient upon arrival and during the follow-up periods. The purpose of this study is to investigate the extent of cardiac involvement in patients with Sydenham's disease and mid-term follow-up of cardiac problems in children hospitalized in Tabriz Children's Hospital. Results 85 children (36 girls and 49 boys) with a ratio of 1:1.3 in the age group of 5-15 years (mean and standard deviation 10.01 ± 3.26) were eligiable in this study. The highest and lowest age group frequency were in 8 years (16 people,) and in 5 and 15 years (2 people, 2.4%) in children with acute rheumatic fever and Syd-enham's chorea. In echography, 42.4% (36 people) had cardiac involvement. Mild mitral valve regurgitation was reported with the highest frequency. As the result showed, 21.5% (12 girls and 6 boys) of children with rhumatic fever were suffering from Syd-enham's chorea, of them, 66.7% (10 girls and 2 boys) had heart involvement mostly mild mitral valve insufficiency. Progression of cardiac involvement in rhe form of mild mitral valve insufficiency (8 people) was mostly seen in girls (12 peo-ple) after 6 months follow-up. At the end of the one-year follow-up period, although mild mitral valve insufficiency in girls was still the most common cardiac complication, it had a slight decrease as compared to 6 monthes follow up (8 people to 7 people). In a one-year follow-up, neurological symptoms improved in 55.6% of patients (10 people), including 33.3% girls (6 people) and 22.2% boys (4 people), most of which were related to the use of sodium valproate (Na Valproate) with the highest prescription in It was girls