Introduction: Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) are still two major public health problems in Iran.
In this retrospective study, we evaluated ARF in children and adults who admited at Bo-Ali and Ali-Asghar – two major medical teaching – hospitals, during the last 12 years.
Materials & Methods: All of data were obtained from medical records of patients who had been discharged with final diagnosis of ARF from march 1995 to march 2006. The diagnosis of ARF was confirmed only if the patients fulfilled the modified Jone's Criteria. The presenting signs and symptoms were determined and findings analyzed by SPSS software.
Results: There were 72 cases with ARF of which 59 cases (82%) were initial and 13 cases (18%) had recurrent attacks of RF. Female to male ratio was 4:5. The mean age of the patients was 15.6 7.4 (mean SD) years, with a range of 3 to 40 years.
The high risk groups were children and young adults who aged 5 to 20 years. (n=59).
The peak incidence of RF in this study was in spring, following the peak incidence of streptococcal pharyngitis.
All of the patients had a history of an upper respiratory tract infection several weeks before.
Positive family history of RF/RHD was present in 5 cases. (6.9%)
The main presenting symptoms were polyarthritis (88.8%), carditis (73.6%), erythema marginatum (2.8%) and chorea (1.4% )respectively.
The number of involved joints was 1 in 1 episode of ARF, 2-5 in 50 and 6-10 in 13.
Knee and ankle joints were most commonly affected.
Atypical arthritis was seen in 22 cases (34.3%) of the 64 episodes of ARF with arthritis.(monoarthritis in 1 case, involvement of cervical spine in 5, hip in 10 and small joints of the hand in 7 cases).
Mitral regurgitation was the most common cardiac valvular lesion observed (19 cases).
Congestive heart failure was seen in 8 cases. (11.1%) Erythema marginatoma was seen in two (5 and 15 years old) females and chorea was seen only in one 13 years old female.
Conclusion: Arthritis and carditis were the most common manifestations in initial and recurrent attacks of ARF in this study. Atypical arthritis was present in a significant proportion of ARF episodes.
Mitral regurgitation was the most common valvular lesion
