Ischemia-modified albumin may not be a Reliable Biomarker in Children with Acute Rheumatic Fever

Aim: Acute rheumatic fever (ARF) poses significant health challenges in developing regions, particularly due to its potential to cause severe cardiac complications. This study investigates the role of ischemia-modified albumin (IMA) as a biomarker for inflammation in children diagnosed with ARF in a moderate altitude area. Methods: Conducted between January 2019 and May 2020 at a regional hospital located at the moderate altitude, the study included 25 ARF patients and a control group of 25 healthy children. Clinical assessments and echocardiographic evaluations were performed, alongside serum IMA level measurements at diagnosis and post-treatment. Results: indicated that while acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated in ARF patients, IMA levels were not significantly different from those in the control group, both at diagnosis and after treatment. Specifically, IMA levels were lower at diagnosis (0.62 ± 0.73 ng/ml) compared to post-treatment (1.18 ± 0.94 ng/ml), with no consistent correlation to CRP, although a negative correlation with ESR was observed. Conclusion: These findings suggest that IMA may not be a reliable biomarker for diagnosing and monitoring ARF in children in moderate region, challenging previous claims about its utility in patients with acute rheumatic fever. Further research is warranted to explore the effects of altitude and other environmental factors on IMA levels in this population.