Abstract
During the year of 1949 till 1957, a total of 199 attacks in 184 cases of rheumatic fever in children were observed at the Pediatric Clinic of Tokyo University Hospital. It appeared that recent increase of rheumatic patients was observed in Japan. According to the statistical analysis of the disease, it occurred particularly in March, April and October, November and December. The first attack was most common between the age of 5 and 12, and 80% of the total cases were fallen in this age group.
Carditis was observed in 54.7%, and polyarthritis in 82.3% of the total cases. As to the minor manifestations, high fever was found in 69.1% and in-creased erythrocyte sedimentation rate in 90.9%. Among the cases of rheumaticcarditis, 19% of the cases showed an insidious or latent onset. Even in such cases, elevated antistreptolysin-O titer and increased erythrocyte sedimentation rate were found. Such a form of carditis was considered to have a great clinical significance because of its high incidence of residual cardiac damage.
A total of 83 cases of rheumatic fever was observed for more than 1 year without prophylactic measures for the recurrence of rheumatic fever. Among these, 14 cases (16.9%) died in the observation period. All these cases had carditis at their first attack. Recurrence rate during observation period was 22.6%, and one half of the recurrences occurred within the first year after the initial attack.
Importance of an early diagnosis of the disease and a prompt therapy was emphasized.
