Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy
Acute rheumatic fever (ARF) is a non-septic complication of group A β-hemolytic streptococcal (GAS) throat infection. Since 1944, ARF diagnosis relies on the Jones criteria, which were periodically revised. The 2015 revision of Jones criteria underlines the importance of knowing the epidemiological...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.621668/full |
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| author | Achille Marino Rolando Cimaz Rolando Cimaz Maria Antonietta Pelagatti Giulia Tattesi Andrea Biondi Laura Menni Marco Sala Patrizia Calzi Francesco Morandi Francesca Cortinovis Anna Cogliardi Claudia Addis Roberto Bellù Massimo Andreotti Tiziana Varisco |
| author_facet | Achille Marino Rolando Cimaz Rolando Cimaz Maria Antonietta Pelagatti Giulia Tattesi Andrea Biondi Laura Menni Marco Sala Patrizia Calzi Francesco Morandi Francesca Cortinovis Anna Cogliardi Claudia Addis Roberto Bellù Massimo Andreotti Tiziana Varisco |
| author_sort | Achille Marino |
| collection | DOAJ |
| description | Acute rheumatic fever (ARF) is a non-septic complication of group A β-hemolytic streptococcal (GAS) throat infection. Since 1944, ARF diagnosis relies on the Jones criteria, which were periodically revised. The 2015 revision of Jones criteria underlines the importance of knowing the epidemiological status of its own region with updated data. This study aims to describe ARF features in a retrospective cohort retrieved over a 10-year timespan (2009–2018) and to report the annual incidence of ARF among children in the Province of Monza-Brianza, Lombardy, Italy during the same period. This is a multicentric cross-sectional/retrospective study; 70 patients (39 boys) were diagnosed with ARF. The median age at diagnosis was 8.5 years (range, 4–14.2 years). Overall, carditis represented the most reported major Jones criteria followed by arthritis and chorea (40, 27, and 20 cases, respectively). In order to calculate the annual incidence of ARF, only children resident in the Province of Monza-Brianza were included in this part of the analysis. Therefore, 47 patients aged between 5 and 14 years were identified. The median incidence during the study time was 5.7/100,000 (range, 2.8–8.3/100,000). In the Province of Monza-Brianza, we found an incidence rate of ARF among children aged 5–14 years constantly above the threshold of low-risk area as defined in the 2015 revision of Jones criteria. Therefore, the diagnosis of ARF should be based on the moderate–high-risk set of Jones criteria. However, given the burden of secondary prophylaxis, expert opinion is advisable when the diagnosis of ARF is uncertain. |
| first_indexed | 2024-12-16T18:48:50Z |
| format | Article |
| id | doaj.art-549d6227d95e442091d55ff0482c61ce |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-16T18:48:50Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-549d6227d95e442091d55ff0482c61ce2022-12-21T22:20:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-02-01810.3389/fmed.2021.621668621668Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern ItalyAchille Marino0Rolando Cimaz1Rolando Cimaz2Maria Antonietta Pelagatti3Giulia Tattesi4Andrea Biondi5Laura Menni6Marco Sala7Patrizia Calzi8Francesco Morandi9Francesca Cortinovis10Anna Cogliardi11Claudia Addis12Roberto Bellù13Massimo Andreotti14Tiziana Varisco15Department of Pediatrics, Desio Hospital, Azienda Socio Sanitaria Territoriale Monza, Monza, ItalyAzienda Socio Sanitaria Territoriale G.Pini-Centro Traumatologico Ortopedico, Milan, ItalyDepartment of Clinical Sciences and Community Health, and Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, Milan, ItalyDepartment of Pediatrics, Milano-Bicocca University Monza e Brianza per il Bambino e la sua Mamma Foundation, Monza, ItalyDepartment of Pediatrics, Milano-Bicocca University Monza e Brianza per il Bambino e la sua Mamma Foundation, Monza, ItalyDepartment of Pediatrics, Milano-Bicocca University Monza e Brianza per il Bambino e la sua Mamma Foundation, Monza, ItalyDepartment of Pediatrics, Vimercate Hospital, Vimercate, ItalyDepartment of Pediatrics, Vimercate Hospital, Vimercate, ItalyDepartment of Pediatrics, Carate Hospital, Carate Brianza, ItalyDepartment of Pediatrics, San Leopoldo Mandic Hospital, ASST Lecco, Lecco, ItalyDepartment of Pediatrics, San Leopoldo Mandic Hospital, ASST Lecco, Lecco, ItalyDepartment of Pediatrics, Lecco Hospital, ASST Lecco, Lecco, ItalyDepartment of Pediatrics, Lecco Hospital, ASST Lecco, Lecco, ItalyDepartment of Pediatrics, Lecco Hospital, ASST Lecco, Lecco, ItalyDepartment of Pediatrics, Desio Hospital, Azienda Socio Sanitaria Territoriale Monza, Monza, ItalyDepartment of Pediatrics, Desio Hospital, Azienda Socio Sanitaria Territoriale Monza, Monza, ItalyAcute rheumatic fever (ARF) is a non-septic complication of group A β-hemolytic streptococcal (GAS) throat infection. Since 1944, ARF diagnosis relies on the Jones criteria, which were periodically revised. The 2015 revision of Jones criteria underlines the importance of knowing the epidemiological status of its own region with updated data. This study aims to describe ARF features in a retrospective cohort retrieved over a 10-year timespan (2009–2018) and to report the annual incidence of ARF among children in the Province of Monza-Brianza, Lombardy, Italy during the same period. This is a multicentric cross-sectional/retrospective study; 70 patients (39 boys) were diagnosed with ARF. The median age at diagnosis was 8.5 years (range, 4–14.2 years). Overall, carditis represented the most reported major Jones criteria followed by arthritis and chorea (40, 27, and 20 cases, respectively). In order to calculate the annual incidence of ARF, only children resident in the Province of Monza-Brianza were included in this part of the analysis. Therefore, 47 patients aged between 5 and 14 years were identified. The median incidence during the study time was 5.7/100,000 (range, 2.8–8.3/100,000). In the Province of Monza-Brianza, we found an incidence rate of ARF among children aged 5–14 years constantly above the threshold of low-risk area as defined in the 2015 revision of Jones criteria. Therefore, the diagnosis of ARF should be based on the moderate–high-risk set of Jones criteria. However, given the burden of secondary prophylaxis, expert opinion is advisable when the diagnosis of ARF is uncertain.https://www.frontiersin.org/articles/10.3389/fmed.2021.621668/fullacute rheumatic fevergroup A β-hemolytic streptococcuscarditisJones criteriapenicillin |
| spellingShingle | Achille Marino Rolando Cimaz Rolando Cimaz Maria Antonietta Pelagatti Giulia Tattesi Andrea Biondi Laura Menni Marco Sala Patrizia Calzi Francesco Morandi Francesca Cortinovis Anna Cogliardi Claudia Addis Roberto Bellù Massimo Andreotti Tiziana Varisco Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy Frontiers in Medicine acute rheumatic fever group A β-hemolytic streptococcus carditis Jones criteria penicillin |
| title | Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy |
| title_full | Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy |
| title_fullStr | Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy |
| title_full_unstemmed | Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy |
| title_short | Acute Rheumatic Fever: Where Do We Stand? An Epidemiological Study in Northern Italy |
| title_sort | acute rheumatic fever where do we stand an epidemiological study in northern italy |
| topic | acute rheumatic fever group A β-hemolytic streptococcus carditis Jones criteria penicillin |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.621668/full |
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