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Of the 161 cases, therefore, which have shown no clinical evidence of activity
during the last eight months, in 84 per cent. the series of E.S.R. readings has never
been above 10, and in 94 per cent has been above 10 in only one isolated instance
in each series. Further, out of 161 cases only 3 showed E.S.R. readings which
persisted above 10 on more than two occasions. (These figures are exclusive of a
few cases in which a transitory rise in the E.S.R. was accompanied by some obvious
intercurrent infection, e.g. tonsillitis.)
It is perhaps worthy of note that 6 out of the 7 cases of active chorea in which
the E.S.R. remained constantly below 10 were definitely more active than any of
the 4 cases where the E.S.R. was above 10.
Conclusions.
(1) In practically every case of active rheumatic carditis the erythrocyte
sedimentation rate is abnormal: and the degree of abnormality of the reading
obtained would appear to be an index of the activity of the disease.
(2) A single abnormal erythrocyte sedimentation rate reading may not indicate
activity of the rheumatic condition.
(3) The erythrocyte sedimentation rate would not appear to offer any indication
of the activity in cases of chorea; but a high erythrocyte sedimentation rate reading
in a case of chorea might suggest the presence of some other active rheumatic lesion.
(4) There would appear to be some evidence that in cases of congestive oedema
the erythrocyte sedimentation rate may be within the normal limits in spite of the
presence of active rheumatic carditis.
I should like to express my thanks to Dr. A. G. L. Reade, medical superintendent
of High Wood hospital, for permission to publish this work.
References.
1 Gray Hill, N. British Journal of Child I Its., 1932, XXIX, 181.
2 Payne, W. W. The Lancet, 1932, I, 74.
3 Bach and Gray Hill. The Lancet, 1932, I, 75.
4 Perry, C. Bruce. Archives of Diseases in Children, October, 1934.
5 Struthers, R. R., and Bacal, H. L. Canadian Med. Assoc. Jour., Montreal, 1933, XXIX, 470.
6 Kahlmeter, G. Rheum. Diseases (Bath Conference), 1928, 219.
7 Peterman, M. G.. and Seager, S. J. Amer. Jour. Dis. Child.., Chicago, 1929, XXXVII, 693.
8 Warner, E. C. Proced. Roy. Soc. Med., Land., 1934, XXVII, 903.
9 Akerren, Y., Uppsala, 1931, X, 473.
10 Faxen, N., Rev. Franc de pediat, Paris, 1934, IX, 809.