[Is rheumatic fever a more severe disease in pre-school children?].

OBJECTIVE: To assess the frequency and characteristics of clinical manifestations of rheumatic fever in children and adolescents according to the age of onset of the disease.

METHODS: We evaluated in a retrospective cohort study the clinical and demographic data of rheumatic fever patients followed at our service for at least 6 months and who attended 2 or more visits.

RESULTS: The charts of 202 children and adolescents with rheumatic fever were evaluated and divided into 3 groups according to the age of the first episode of rheumatic fever: group 1- patients under 5 years old (8 [4%]), group 2- patients between 5 and 9 years (84 [42%]) and group 3 patients with 10 years old or older (110 [54%]). The mean follow-up was 4.1 years. Carditis occurred in 24%, 42% and 50%; arthritis in 75%, 71% and 69% and chorea in 25%, 37% and 34% in groups 1, 2 and 3 respectively. There was no statistical difference between the groups in relation to the frequency of such events and of severe carditis, however we observed lower numeric frequency of carditis and Sydenham chorea in children younger than 5 years.

CONCLUSIONS: Rheumatic fever, although less frequent, can be found in children under 5 years with no significant difference in relation to the frequency or severity of clinical manifestations.