Increased ischaemia-modified albumin is associated with inflammation in acute rheumatic fever.

INTRODUCTION

Ischaemia-modified albumin, a novel biochemical marker for tissue ischaemia, was found to be associated with oxidative stress. The purpose of this study was to assess the role of ischaemia-modified albumin in the diagnosis of acute rheumatic fever and also to evaluate the ischaemia-modified albumin levels in children with heart valve disease.

METHODS

The study groups, aged 5-18 years, consisted of 128 individuals - 40 with acute rheumatic fever, 35 with congenital heart valve disease, 33 with chronic rheumatic heart disease, and 20 healthy control subjects.

RESULTS

The ischaemia-modified albumin, erythrocyte sedimentation rate, and C-reactive protein levels of the acute rheumatic fever group were significantly higher than those in the chronic rheumatic heart disease, congenital heart valve disease, and control groups, separately (p < 0.001). The ischaemia-modified albumin levels in both carditis and isolated arthritis subgroups of children with acute rheumatic fever were significantly higher than in the control group (p < 0.001, p < 0.01, respectively). However, there was no statistically significant difference between the chorea subgroup and control subjects. In addition, significant correlations were observed between ischaemia-modified albumin and acute phase reactants of patients with acute rheumatic fever (p < 0.001 for both erythrocyte sedimentation rate and C-reactive protein). The ischaemia-modified albumin levels of chronic rheumatic heart disease, congenital heart valve disease, and control subjects were similar.

CONCLUSIONS

The increased level of ischaemia-modified albumin in children with acute rheumatic fever seems to be associated with inflammation. However, further studies are needed to provide stronger evidence.