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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
484
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

544
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
544
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
493

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Related Experiment Video

Updated: May 5, 2026

Rapid Magnetic-microbead Method for Efficient Purification of Low-density Neutrophils
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Neutrophil Count and Neutrophil-to-Lymphocyte Ratio Predict Rheumatic Heart Disease in Children With Acute Rheumatic

Hülya Akat1,2, Halil Keskin1, Fuat Laloglu3

  • 1Pediatrics, Atatürk University Faculty of Medicine, Erzurum, TUR.

Cureus
|May 4, 2026
PubMed
Summary

Neutrophil count and neutrophil-to-lymphocyte ratio (NLR) may help identify children at risk for rheumatic heart disease (RHD). Higher levels in acute rheumatic fever (ARF) patients indicate inflammation and potential cardiac involvement.

Keywords:
acute rheumatic feverinflammationneutrophil countneutrophil-to-lymphocyte ratiorheumatic heart disease

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Area of Science:

  • Pediatric Rheumatology
  • Inflammatory Markers
  • Cardiovascular Disease

Background:

  • Acute rheumatic fever (ARF) is a significant cause of acquired heart disease in children, especially in low- and middle-income countries.
  • There is a need for simple inflammatory markers to assess ARF activity and predict cardiac involvement, specifically rheumatic heart disease (RHD).
  • This study investigates neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and mean platelet volume (MPV) as potential markers in pediatric ARF.

Purpose of the Study:

  • To evaluate neutrophil count, NLR, and MPV in pediatric patients diagnosed with ARF.
  • To assess the potential predictive value of these hematological parameters for the development of RHD.
  • To correlate inflammatory markers with disease activity and cardiac outcomes in ARF.

Main Methods:

  • Retrospective analysis of clinical, laboratory, and echocardiographic data from pediatric ARF patients (June 2015 - July 2020).
  • Comparison of hematological parameters (neutrophil count, lymphocyte count, MPV, P-LCR) between ARF patients and healthy controls.
  • Receiver operating characteristic (ROC) curve analysis to determine the predictive performance of neutrophil count and NLR for RHD development.

Main Results:

  • ARF patients exhibited significantly higher neutrophil counts and NLR compared to healthy controls; platelet indices showed no significant difference.
  • A positive correlation was found between NLR and C-reactive protein (CRP) levels, indicating increased inflammation.
  • Higher neutrophil counts at diagnosis were associated with persistent valvular involvement, and ROC analysis showed moderate predictive value for neutrophil count (AUC=0.72) and NLR (AUC=0.68) in predicting RHD.

Conclusions:

  • Neutrophil count and NLR may serve as indicators of inflammatory activity in pediatric ARF.
  • These markers show potential in identifying patients at higher risk for developing RHD, although with moderate predictive performance.
  • Further prospective studies are recommended to validate these preliminary, hypothesis-generating findings.