152 Am J Exp Clin Res, Vol. 3, No. 2, 2016 http://www.ajecr.org American Journal of Experimental and Clinical Research Am J Exp Clin Res 2016;3(2):152-156 Original Article Clinical assessment and echocardiography follow-up results of the children with acute rheumatic fever Ahmet Basturk 1 *, Kazim Oztarhan 2 , Sultan Kavuncuoglu 2 , Cemal Polat 3 1 Department of Pediatric Gastroenterology, Faculty of Medicine, Akdeniz University, Dumlupinar Bulvari-Campus, Antalya, Turkey 2 Department of Pediatrics, Istanbul Kanuni Sultan Süleyman Research and Teaching Hospital, I stanbul, Turkey 3 Department of Biochemistry, Public Health Laboratuary, Kütahya, Turkey Abstract. Acute rheumatic fever (ARF) is an inflammatory collagenous tissue disease which shows its cardinal signs in joints, heart, skin and nervous system while affecting whole connective tissue system more or less. This study was conducted in order to investigate the clinical pattern and severity of ARF, echocardiographic findings and the course of the patients with heart valve involvement by studying the clinical and laboratory aspects of the patients diagnosed with ARF according to updated Jones Criteria. The study included 214 patients diagnosed with ARF for the first time between January 2005 and May 2008. All patients were scanned with doppler echocardiography (ECHO) between certain intervals. Severity of carditis was grouped into 3 groups of mild, moderate and severe. The frequency of carditis was 57.9%, arthritis was 73.4%, chorea was 11.7% and erythema marginatum was 0.9% but no subcutaneous nodules. Recovery was observed in 22% of the cases of isolated aortic insufficiency (AI), 50% of the cases with isolated mitral insufficiency (MI) and 80% of the cases with mitral and aortic insufficiencies together (MI+AI). Recovery in isolated MI was significantly much more than recovery in isolated AI. However, recovery in AI was significantly much more than in MI in cases of mitral and aortic insufficiencies together. In conclusion, ARF is a cause of acquired and preventable heart disease and it can be reversed through right diagnosis and appropriate treatment. Isolated mitral insufficiency, isolated aortic insufficiency and both mitral and aortic insufficiency are observed during a valvular disease. Remission among valvular diseases are most commonly in those with mitral insufficiency and remissions in both mitral and aortic insufficiency occur most commonly in aortic ones. Regular prophylaxis is the key element for long term prevention of patients with ARF. Keywords: Acute rheumatic fever, echocardiography, children, carditis, mitral insufficiency, aortic insufficiency Introduction Acute rheumatic fever (ARF) is a systemic inflammatory disease that can involve heart, joints, skin, subepidermal tissues and brain. It is a result of a delayed reaction to acute pharyngeal infections caused by Group A ß-Hemolytic Streptococci. ARF can manifest with arthritis, carditis, subcutaneous nodules, and erythema marginatum and sydenham chorea in a certain amount of time (approx. 3 weeks) after the infection. ARF doesn’t necessarily develop in every individual who had streptococcal pharyngitis. Probability of ARF developing is 0.5-3%. As the most important cause of mortality and morbidity of the disease is carditis, it can cause heart failure and death due to pancarditis during acute phase. However, most common result is development of permanent dysfunction of the affected heart valves like stenosis or insufficiency which happens years after the episode [1, 2]. Although incidence is getting low in developed countries during the century, it is still a significant public health problem in developing countries [3]. T. Duckett Jones established criteria concerning ARF and recurrences in 1944. These criteria, which are used today, were reviewed preserving the core features in 1965 and 1984 and in 1992 they took their latest form [4]. This study was conducted in order to investigate the clinical pattern and severity of the disease, echocardio- graphic findings and the course of the patients with heart valve involvement by studying the clinical and laboratory aspects of the patients diagnosed with ARF according to updated Jones Criteria. Materials and Methods This study included 214 patients diagnosed with acute ARF for the first time between January 2005 and May 2008 at the Pediatric Clinic of Istanbul Bakırköy Obstetrics and Pediatrics Research and Training Hospital. Approval by the Ethics Committee of the Istanbul Bakırköy Obstetrics and Pediatrics Research and Training Hospital ___________________________________________________________ * Corresponding author: Ahmet Basturk (drahmetbasturk@hotmail.com).