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HASSAN A. MAJEED, MRCPI, DCH
Department of Pediatrics Faculty of Medicine University of Kuwait PO Box 24923 Safat, Kuwait

Am J Dis Child. 1985;139(5):441-442.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—Data from our study¹ strongly supported the concept² that if the host escapes carditis in the initial attack, he or she will continue to do so in subsequent recurrences. After reviewing these data^1,2 we suggested that "the regimen [for secondary prophylaxis] should be selective... patients who escape carditis in the initial attack should maintain prophylaxis for five years. The duration of five years is admittedly arbitrary but is based on earlier observations that recurrences are most common during the first few years after the index attack."^1,3

The statement by Professor Sanyal that "some children with polyarthritis may have subclinical carditis that makes them unduly susceptible to cardiac involvement during subsequent attacks of ARF" lacks evidence; furthermore, we have already highlighted our reservations on the retrospective study of Kuttner and Mayer.⁴ It is very interesting that the experience of Professor Sanyal with recurrences "... where . . . [Full Text PDF of this Article]

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