We are happy that the guidelines have drawn this level of interest and
welcome the tradition of healthy criticism. To bring out a consensus
statement on this subject was a tremendous job for the committee due
to diversity in practical approach at the institutional and individual
levels. First of all we are thankful for pointing out the fact that
arthralgia and increase PR intervals are not included as minor
criteria in presence of arthritis and carditis, respectively. We
regret this inadvertent mistake. Regarding the ASLO/ Anti DNAs B
levels, it must be clarified that laboratory value prevalent in the
geographical area must be defined and used. We have mentioned values
available in literature. Leukocytosis is still retained as a part of
acute phase reactant in WHO 2001 update and in current IAP guidelines
though ESR and ASLO are more important. Leukocytosis has a role when
ESR values are not reliable.
Many of other concerns were discussed in detail
during discussion, like weight cut-off in relation to doses of
benzathine penicillin G injection and its dosing schedule, doses of
cephalexin and use of sulfa drugs etc. Hopefully, Cardiology chapter
of IAP would be able to address these issues in near future.
National Consultative meeting on ARF/RHD.