Serum cholesterol levels in patients with acute rheumatic fever

M. Panamonta, N. Settasatian, E. L. Kaplan and A. Chaikitpinyo
Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand.

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.