Caspian Journal of Pediatrics

en Acute Rheumatic Fever in Children in the Echocardiography Era: Contemporary Clinical Priorities and Lessons from a 10-Year Tehran Inpatient Cohort عمومى General پژوهشي Research <div style="text-align: justify;">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.</div> Acute Rheumatic Fever, Antistreptolysin O, Arthritis, Children, Echocardiography, Mitral Regurgitation, Penicillin 0 0 http://caspianjp.ir/browse.php?a_code=A-10-385-1&slc_lang=en&sid=1 Atefeh Habibi Atefeh.habibi@sums.ac.ir 0000-0003-2331-1226 No Department of Pediatrics, Namazi Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mahmoud Khodabandeh khodabandeh@farabi.tums.ac.ir 0000-0002-1567-5284 No Department of Pediatric Infectious Diseases, Children’s Medical Center, Pediatrics Center of Excellence, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Behzad Mohammadpour Ahranjani behzadpediatr@yahoo.com 0000-0001-8277-9385 No Department of Pediatric Cardiology, Bahrami Children's Hospital , Tehran University of Medical Sciences Payman Sadeghi p-sadeghi@tums.ac.ir 0000-0002-3217-7199 Yes Department of Pediatrics, Namazi Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran