Adrenomedullin and total nitrite levels in children with acute rheumatic fever.

Objective: To investigate the levels of adrenomedullin (AM) and total nitrite, a stable product of nitric oxide (NO), in children with acute rheumatic fever (ARF).

Design And Methods: Eleven children with ARF were investigated in comparison with 14 healthy controls. Adrenomedullin was detected by HPLC, while total nitrite was quantitated by the Griess reaction.

Results: Plasma urinary AM and total nitrite levels were significantly higher in children with ARF, irrespective of whether they were in the acute or convalescent phase of disease. Plasma AM (pmol/mL) levels were 49.19 +/- 3.23 in the acute phase, 44.52 +/- 4.26 in the convalescent phase, 35.49 +/- 3.43 in controls, and urinary AM excretion (pmol/mg creatinine) was 43.45 +/- 18.40 in the acute phase, 32.38 +/- 15.37 in the convalescent phase, and 24.84 +/- 11.38 in controls. Plasma total nitrite levels (mumol/L) were 75.37 +/- 13.13 in the acute phase, 59.81 +/- 12.78 in the convalescent phase, and 41.09 +/- 10.27 in controls. Urinary total nitrite excretion (mumol/mg creatinine) was 3.82 +/- 1.56 in the acute phase, 2.15 +/- 0.58 in the convalescent phase, and 1.33 +/- 0.61 in controls. The differences were statistically significant for all (P < 0.05).

Conclusion: This study considered that AM and NO may have a role in the immunoinflammatory process of ARF.