Javadi Vadood, Mansourizadeh Elham, Pourmoshtagh Hassan, Rahmani Khosro, Hassas Yeganeh Mehrnoosh
Department of Pediatric Rheumatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pediatrics, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2024 Spring;15(2):328-333. doi: 10.22088/cjim.15.2.328.
In Iran, there is a lack of information and studies on acute rheumatic fever (ARF), a global health issue. The limited understanding of ARF's prevalence and primary clinical symptoms has led to confusion. This research investigates the characteristics of children aged 3-17 years who experience ARF with monoarthritis as their initial symptom.
A retrospective evaluation of medical records of children diagnosed with ARF was conducted. The study aimed to determine the prevalence of monoarthritis as the first manifestation of ARF and its association with age, gender, family history, and cardiac involvement. Categorical variables were analyzed using the chi-square test with a significance level of < 0.05 and a confidence interval of 95%, using SPSS software (Version 23).
The study included 62 patients with ARF, comprising 41 (66.1%) boys with an average age of 8.48±3.27 years. Among these patients, 12 exhibited cardiac involvement according to the revised Jones criteria, with 5 clinical carditis and 7 cases of subclinical carditis. Monoarthritis was the initial symptom in seven patients (11.29%); five (71.4%) also had carditis. There was a significant association () between monoarthritis and carditis.
The study concludes that monoarthritis may be an early sign of ARF in children and correlates significantly with cardiac involvement. However, more extensive research with more significant participant numbers is necessary to understand ARF in Iran comprehensively. A thorough cardiac examination is also crucial for patients with ARF and monoarthritis.
在伊朗，作为一个全球性健康问题的急性风湿热（ARF）缺乏相关信息和研究。对ARF患病率和主要临床症状的有限了解导致了混淆。本研究调查了以单关节炎为初始症状的3至17岁患ARF儿童的特征。
对诊断为ARF的儿童病历进行回顾性评估。该研究旨在确定单关节炎作为ARF首发表现的患病率及其与年龄、性别、家族史和心脏受累的关系。使用SPSS软件（版本23），采用卡方检验对分类变量进行分析，显著性水平<0.05，置信区间为95%。
该研究纳入了62例ARF患者，其中包括41例（66.1%）男孩，平均年龄为8.48±3.27岁。在这些患者中，根据修订的琼斯标准，12例出现心脏受累，其中5例为临床心肌炎，7例为亚临床心肌炎。单关节炎是7例患者（11.29%）的初始症状；5例（71.4%）也患有心肌炎。单关节炎与心肌炎之间存在显著关联（）。
该研究得出结论，单关节炎可能是儿童ARF的早期迹象，并且与心脏受累显著相关。然而，需要进行更广泛、参与人数更多的研究，以全面了解伊朗的ARF。对ARF和单关节炎患者进行全面的心脏检查也至关重要。
