Nurdan EROL, Merve ÖZEN, Abdülkadir BOZAYKUT

A major diagnostic criterion for acute rheumatic fever: Clinical and sub-clinical carditis accompaniment with Sydenham chorea

Objective: Acute rheumatic fever is a prevalent cause of heart disease affecting the whole world. Sydenham chorea, caused by the group A β-hemolytic streptococcus bacteria and characterized by non-rhythmic involuntary movements, is one of the major symptoms of acute rheumatic fever. While Sydenham chorea can be the only symptom in some acute rheumatic fever cases, in others it can also be accompanied by carditis findings. We have conducted this study to examine the co-occurrence of Sydenham chorea with clinical and sub-clinical carditis. Material and Methods: The records of the cases diagnosed with Sydenham chorea and monitored in our hospital between November 2015 and November 2020 were scanned retrospectively. SPSS 21 was used for data analysis. Results: The sample consisted of 22 (84.6%) females and 4 (15.4%) males. Chorea was accompanied by arthritis in 6 cases (23%) and by carditis in 22 cases (84.6%), while 4 cases had pure chorea. The severity of the valve involvement was mild in 8, moderate in 10, and severe in 4 cases. During the follow-up of the 22 cases with carditis, valve involvement disappeared in 27.3%, decreased in 36.35%, and remained the same in 36.35%. Valve involvement developed during the follow-up of one case that did not previously have heart involvement (3.8%). Conclusion: In our study carditis was observed at a significant rate in Sydenham chorea cases. Echocardiography plays an important role in the diagnosis of carditis, hence the diagnosis of acute rheumatic fever, which is a serious problem especially in developing countries.

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