July 1993

Serum Cholesterol Levels in Patients With Acute Rheumatic Fever

Author Affiliations

From the Department of Pediatrics, Faculty of Medicine (Drs Panamonta and Chaikitpinyo), and Department of Clinical Chemistry, Faculty of Associated Medical Sciences (Dr Settasatian), Khon Kaen (Thailand) University; and Department of Pediatrics, University of Minnesota Medical School, Minneapolis (Dr Kaplan).

Am J Dis Child. 1993;147(7):732-736. doi:10.1001/archpedi.1993.02160310034013

• Objective.  —To determine abnormalities of cholesterol metabolism in children with acute rheumatic fever (ARF).

Design.  —Cross-sectional study and prospective study.

Setting.  —Pediatric ward of the Khon Kaen (Thailand) University Hospital.

Participants.  —Forty-six confirmed patients with ARF (during the acute and recovery phases of disease), 51 siblings, and 92 age- and sex-matched control children.

Interventions.  —None.

Measurements/Main Results.  —Serum samples of these children were studied for serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels and liver function tests. No significant differences were found in mean serum total cholesterol levels (3.68±0.86 mmol/L [142.4±33.3 mg/dL] vs 3.75±0.67 mmol/L [145.0±25.8 mg/dL], 3.79±0.75 mmol/L [146.4±29.0 mg/dL], and 3.80±0.59 mmol/L [146.9±23.0 mg/dL]) or mean triglyceride levels (1.19±0.33 mmol/L vs 1.16±0.51, 1.12±0.37, and 1.07±0.41 mmol/L) (during ARF vs after ARF, sibling, and age- and sex-matched control children, respectively). The children with ARF had significantly lower mean levels of high-density lipoprotein cholesterol and of albumin than did the other groups (analysis of variance, P<.0001). In the ARF group, high-density lipoprotein cholesterol and albumin levels varied inversely with the clinical severity of carditis, while, in contrast, triglyceride and alkaline phosphatase levels varied with the clinical severity of carditis. Conclusions.—This study confirms abnormalities of cholesterol metabolism in ARF. Hepatic dysfunction associated with the clinically detectable severity of carditis or inflammation might explain the observed differences in serum high-density lipoprotein cholesterol and triglyceride levels in these children.(AJDC. 1993;147:732-736)