CLINICAL FEATURES OF ACUTE RHEUMATIC FEVER IN PEDIATRIC PATIENTS: FINDINGS FROM A SINGLE-CENTER TERTIARY CARE HOSPITAL
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Keywords
Rheumatic Heart Disease, Acute Rheumatic fever, Carditis, Arthritis, Mitral Stenosis, Valvular Heart Disease
Abstract
Objective: To explore and record the clinical features of acute rheumatic fever in pediatric patients at a tertiary care hospital in Karachi, Pakistan.
Methodology: Clinical features of acute rheumatic fever (ARF) in children aged 1 to 14 years was evaluated in this descriptive cross-sectional study, which took place at Abbasi Shaheed Hospital, Karachi Medical and Dental College, from January, 2023 to June 2023. Exclusions included co-morbidities like diabetes, kidney and liver diseases, inactive rheumatic heart disease, and HIV. Ethical approval and informed consent were obtained. Data collection encompassed medical history, physical exams, ECG, chest x-ray, and essential labs, with echocardiography performed on all participants. ARF diagnosis followed the Modified Jones Criteria, classifying carditis into no carditis, mild, moderate, and severe. Version 23.0 of the IBM-SPSS was utilized to analyze the data.
Results: The study included 86 children with acute rheumatic fever (ARF), with a mean age of 8.4 ± 3.2 years; 65.1% were between 4-12 years old. The cohort comprised 62.8% females and 37.2% males, with 58.1% residing in rural areas. A significant number, 60.5%, had symptoms for over a month, and 19.8% had parents with no formal education. Arthritis was significantly more common in first episodes (70.8%) than recurrences (29.0%, p<0.0001), while severe carditis was predominantly seen in recurrent cases (56.5%, p<0.0001). Valvular lesions such as mitral stenosis was more frequent in recurrences (32.3% vs. 16.7%, p=0.048), and mixed valvular lesions were notably more frequent in recurrent cases (35.5% vs. 33.3%, p=0.043).
Conclusion: This study emphasizes the significant impact of ARF, highlighting the necessity for early diagnosis, prompt treatment, and effective preventive measures, especially in underdeveloped areas.
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Dr Kiran Fatima
Assistant Professor, Pathology Department, Rawalpindi Medical University, Pakistan
Dr Sultan Mustafa
Professor, Department of Paediatrics, Abbasi Shaheed Hospital KMDC, Karachi, Pakistan
Dr Riffat Farrukh
Assistant Professor, Department of Paediatrics, Abbasi Shaheed Hospital, KMDC, Karachi, Pakistan
Dr Ibrahim Shakoor
Professor of Paediatrics, Department of Paediatrics, Abbasi Shaheed Hospital, KMDC, Karachi, Pakistan
Dr Shaheen Masood
Assistant Professor, Paediatrics Department, KMDC & Abbasi Shaheed hospital, Pakistan
Dr Amber Naseer
MCPS, Paedriatics, Senior Registrar, Abbasi Shaheed Hospital, KMDC, Karachi, Pakistan