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 (μmol/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 (μmol/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.