Volume 12, Issue 1 (2026)
CJP 2026, 12(1): e4 |
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Habibi A, Khodabandeh M, Mohammadpour Ahranjani B, Sadeghi P. Acute Rheumatic Fever in Children in the Echocardiography Era: Contemporary Clinical Priorities and Lessons from a 10-Year Tehran Inpatient Cohort. , CJP. 2026; 12 (1) : e4
URL: http://caspianjp.ir/article-1-300-en.html
URL: http://caspianjp.ir/article-1-300-en.html
Department of Pediatrics, Namazi Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , p-sadeghi@tums.ac.ir
Abstract: (4 Views)
Background and Objective: Acute rheumatic fever (ARF) remains a preventable cause of acquired heart disease in children, but contemporary Iranian data are limited. We characterized clinical manifestations, echocardiographic findings, treatment patterns, and in-hospital outcomes at a tertiary pediatric center in Tehran.
Methods: This retrospective descriptive study included children hospitalized with first-episode ARF at Bahrami Children’s Hospital, Tehran, between September September 23, 2012 and September 23, 2022. Diagnoses were retrospectively assessed according to the 2015 revised Jones criteria for moderate- to high-risk populations. Demographic, clinical, laboratory, echocardiographic, treatment, and in-hospital outcome data were analyzed descriptively.
Findings: Twelve children were included (mean age 9.8 ± 2.8 years; 58.3% male). Arthritis occurred in 11 (91.7%): nine with migratory and two with additive arthritis. One child presented with Sydenham chorea. Antistreptolysin O titers were elevated in 11 (91.7%). Echocardiography demonstrated mitral regurgitation in 11 (91.7%): five with isolated mild regurgitation and six with combined mitral–aortic regurgitation classified as moderate-to-severe. Three of the latter had mild left ventricular dilatation. All patients received intramuscular benzathine penicillin G and were prescribed secondary prophylaxis. Arthritis improved in all affected children. Repeat echocardiography showed no documented deterioration during hospitalization. No major in-hospital complications or deaths occurred.
Conclusion: Arthritis predominated, and valvular abnormalities were frequent in this small retrospective cohort. Without longitudinal follow-up, long-term cardiac outcomes and treatment effectiveness cannot be established. Standardized assessment, sustained secondary prophylaxis, and longitudinal echocardiographic surveillance remain priorities. A national ARF registry in Iran could support multicenter research and long-term monitoring.
Methods: This retrospective descriptive study included children hospitalized with first-episode ARF at Bahrami Children’s Hospital, Tehran, between September September 23, 2012 and September 23, 2022. Diagnoses were retrospectively assessed according to the 2015 revised Jones criteria for moderate- to high-risk populations. Demographic, clinical, laboratory, echocardiographic, treatment, and in-hospital outcome data were analyzed descriptively.
Findings: Twelve children were included (mean age 9.8 ± 2.8 years; 58.3% male). Arthritis occurred in 11 (91.7%): nine with migratory and two with additive arthritis. One child presented with Sydenham chorea. Antistreptolysin O titers were elevated in 11 (91.7%). Echocardiography demonstrated mitral regurgitation in 11 (91.7%): five with isolated mild regurgitation and six with combined mitral–aortic regurgitation classified as moderate-to-severe. Three of the latter had mild left ventricular dilatation. All patients received intramuscular benzathine penicillin G and were prescribed secondary prophylaxis. Arthritis improved in all affected children. Repeat echocardiography showed no documented deterioration during hospitalization. No major in-hospital complications or deaths occurred.
Conclusion: Arthritis predominated, and valvular abnormalities were frequent in this small retrospective cohort. Without longitudinal follow-up, long-term cardiac outcomes and treatment effectiveness cannot be established. Standardized assessment, sustained secondary prophylaxis, and longitudinal echocardiographic surveillance remain priorities. A national ARF registry in Iran could support multicenter research and long-term monitoring.
Article number: e4
Keywords: Acute Rheumatic Fever, Antistreptolysin O, Arthritis, Children, Echocardiography, Mitral Regurgitation, Penicillin
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