Cortisone Therapy of Rheumatic Fever: Relation of Clinical Response to Levels of Serum Protein-Bound Iodine, Serum Corticoids and Urinary 17-Ketosteroids*

The clinical and laboratory data on a group of 53 children ranging inage from 4 to 15 years and treated for initial attacks of rheumatic carditis with large amounts of cortisone have been presented previously (1, 2). The return of the abnormal cardiologic findings to normal in children with earlier unequivocal evidences of myocarditis seemed to depend upon the duration of illness prior to treatment; at present 12 of the 14 treated within two weeks of onset have normal hearts, and 16 of the 27 treated two to six weeks after onset have no cardiac abnormalities, with 3 others having only non-transmitted grade I systolic apical murmurs. This favorable outcome contrasts sharply with the finding that only 1 of the 14 treated after six weeks of illness now has a normal heart. The followup period extends from three to thirty-nine months.