Fiebre reumática aguda: 27 años de experiencia en los hospitales pediátricos en Montreal

Objetivos Revisar la epidemiologia, las caracteristicas clinicas y la evolucion de una cohorte de ninos, durante 27 anos, con fiebre reumatica aguda en Montreal (Canada). Metodos Las historias clinicas de ninos menores de 18 anos hospitalizados y diagnosticados de fiebre reumatica en Montreal, entre enero de 1979 y diciembre de 2005, fueron revisadas. Resultados De las 134 historias seleccionadas, 36 ninos eran seguidos por fiebre reumatica cronica, los 98 pacientes restantes (51 % de sexo femenino) cumplian los criterios diagnosticos de fiebre reumatica aguda y fueron incluidos en el analisis. La edad media en el momento del diagnostico era de 10,1 ± 3,0 anos (intervalo: 3-17). Durante los 27 anos del periodo de estudio, hubo una incidencia media de 3,6 pacientes por ano sin picos de incidencia, sin embargo dos tercios de los casos se presentaron en los ultimos 15 anos. El 49 % de los pacientes habian nacido en Canada y no nativos (NCnN), el resto eran nativos nacidos en Canada (NCN) o nacidos en el extranjero (NE). La carditis fue diagnosticada en el 73 % de los pacientes y la corea de Sydenham en el 49 %. De los ninos NCnN, el 39 % presentaban carditis comparativamente al 61 % de los ninos de otro origen (p = 0,003). Sin embargo, la corea fue el modo de presentacion en el 69 % de los ninos NCnN frente al 31% en ninos de otro origen (p Conclusion La fiebre reumatica aguda en Montreal, a pesar de ser una enfermedad rara, ha presentado una incidencia constante en los ultimos 27 anos, la presentacion clinica depende del origen etnico.

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