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Pulse therapy combined with oral corticosteroids in the management of severe rheumatic carditis and rebound.
Torres, Renato P A; Torres, Rômulo F A; Torres, Rafael A; Torres, Rosângela S L A.
Afiliação
  • Torres RPA; 1Department of Pediatric Cardiology,Hospital Pequeno Principe,Curitiba,PR,Brazil.
  • Torres RFA; 2Department of Cardiology,Instituto Dante Pazzanese de Cardiologia,São Paulo,SP,Brazil.
  • Torres RA; 3Department of Cardiology,Instituto de Neurologia e Cardiologia de Curitiba,Curitiba,PR,Brazil.
  • Torres RSLA; 4Universidade Positivo,Curitiba,PR,Brazil.
Cardiol Young ; 28(2): 309-314, 2018 Feb.
Article em En | MEDLINE | ID: mdl-29065944
OBJECTIVE: The aim of the present study was to describe the clinical course, laboratory tests, and the cardiac involvement in rheumatic carditis patients in functional class III and IV, submitted to pulse therapy combined with oral prednisone. METHODS: A total of 120 patients with severe carditis due to acute rheumatic fever were treatment with three cycles of pulse therapy combined with oral corticosteroids. The patients were followed up from the hospital admission until the end of the treatment and returned after 30, 60, and 90 days to control. The patients were evaluated by clinical, laboratory, and transthoracic echocardiogram. RESULTS: In total, 23 (19.2%) patients at first attack of rheumatic fever and 97 (80.8%) with recurrent carditis were evaluated. Cardiac surgery was performed in 8 (6.6%) patients. The patients showed improved laboratory and radiological parameters (p<0.001) and were discharged, 74 (61.7%) in functional class I and 46 (38.3%) in functional class II. Hospitalisation time ranged from 21 to 176 days, with a mean of 69.1 days. Reduction of left atrium and ventricle diameters was observed, measured by means of transthoracic echocardiography, at hospital admission and discharge (p<0.001). None of the patients experienced rebound. CONCLUSIONS: The pulse therapy was effective in controlling severe rheumatic carditis and the oral corticosteroid prevented rebound episodes. Prolonged hospital stay was required for the clinical stabilisation of patients and to avoid the interruption of medication.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Febre Reumática / Cardiopatia Reumática / Corticosteroides / Miocardite Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Cardiol Young Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / PEDIATRIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Febre Reumática / Cardiopatia Reumática / Corticosteroides / Miocardite Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Cardiol Young Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / PEDIATRIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido