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November 1977

Thrombocytosis in Rheumatic Fever

Arch Intern Med. 1977;137(11):1639. doi:10.1001/archinte.1977.03630230107032

To the Editor.—  Thrombocytosis is recognized as an associated feature of autoimmune collagen and malignant diseases.1-4 In rheumatoid arthritis, a positive correlation has been demonstrated between thrombosis and the activity of the disease.2,5-8 The occurrence of thrombocytosis in acute rheumatic fever has been mentioned incidentally by several authors.2,4,9 The present report describes a striking correlation between the activity of the disease and the platelet count of a patient with acute rheumatic fever (Table).

Report of a Case.—  A 15-year-old boy was hospitalized because of fever and arthritis that affected both ankles. A harsh, blowing, holosystolic murmur was heard over the apical area. Pertinent laboratory findings were as follows: ESR, 110 mm after one hour (Westergren); hemoglobin level, 12 gm/100 ml; and WBC count, 4,500/cu mm. The serum globulin value was 4.1 gm/ 100 ml; the serum albumin value was 3.8 gm/100 ml. Serum electrophoresis revealed an increase

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