Akut Romatizmal Ateşli Hastaların Değerlendirilmesi: 13 Yıllık Tek Merkez Deneyimi

Abstract

Amaç: Türkiye'de akut romatizmal ateşin sıklığına ilişkin veriler sınırlıdır. Çalışmanın amacı Doğu Karadeniz Bölgesi'nde akut romatizmal ateş tanısıyla takip edilen hastaların demografik ve klinik özelliklerinin retrospektif olarak değerlendirilmesidir. Gereç ve Yöntemler: Kliniğimizde Ocak 2005 ile Aralık 2017 tarihleri arasında akut romatizmal ateş tanısı alan hastaların demografik, klinik ve laboratuvar özellikleri arşiv kayıtlarından değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 11±3,52 yıl (26 ay-17 yıl), kadın/erkek oranı 1,38 olan 175 hasta dahil edildi. Hastalar en sık Şubat, Mayıs ve Ağustos aylarında başvurdu. En sık görülen majör bulgu kardit (%80) iken, artrit %51,4, kore ise %16 oranında görüldü. Sadece bir hastada eritema marjinatum mevcuttu. Kardit hastalarında en sık izole mitral kapak tutulumu (%54,3) görülürken, eş zamanlı mitral ve aort kapak tutulumu hastaların %30,7'sinde, izole aort kapak tutulumu ise %10 oranında saptandı. Mitral tutulumu olan üç (%2,1) hastada triküspit yetersizliği görüldü. Sekonder profilaksi ile uyumsuz olan yedi hastanın dördünde (%57,1) nüks tespit edildi. Klinik takip sırasında iki hastaya mitral ve aort kapak değişimi uygulandı. Hastalarda mortalite görülmedi. Sonuç: Türkiye'de son yıllarda sosyo-ekonomik koşullardaki iyileşmeye rağmen akut romatizmal ateş, Doğu Karadeniz Bölgesi için önemli bir sağlık sorunu olmaya devam etmektedir.

Keywords

• Akut romatizmal ateş
• Kardit
• Çocuk
• Romatizmal kalp hastalığı

Evaluation of Patients with Acute Rheumatic Fever: 13-Year Experience of a Single Center

Abstract

Background/Aims: Data on the frequency of acute rheumatic fever in Turkey is limited. The study aims to evaluate patients' demographic and clinical characteristics retrospectively followed up with a diagnosis of acute rheumatic fever in the Eastern Black Sea Region. Materials and Methods: Demographic, clinical and laboratory characteristics of patients diagnosed with acute rheumatic fever in our clinic between January 2005 and December 2017 were evaluated from archival records. Results: Included in the study were 175 patients with a mean age of 11±3.52 years (26 months–17 years), with a female/male ratio of 1.38. Patients are most frequently presented in February, May and August. Carditis was the most common (80%) major finding, while arthritis was seen in 51.4% and chorea in 16%. Erythema marginatum was present in only one patient. While isolated mitral valve involvement (54.3%) was most common in the patients with carditis, simultaneous mitral and aortic valve involvement was found in 30.7% of the patients, and isolated aortic valve involvement in 10%. Tricuspid regurgitation was seen in three (2.1%) patients with mitral involvement. Recurrence was detected in four (57.1%) of the seven patients who were incompatible with secondary prophylaxis. During clinical follow-up, two patients underwent mitral and aortic valve replacement. No mortality was observed in the patients. Conclusion: Despite improving socio-economic conditions in Turkiye in recent years, acute rheumatic fever remains a significant health problem for the Eastern Black Sea Region.

Keywords

• Acute rheumatic fever
• Carditis
• Children
• Rheumatic heart disease

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