Serum intercellular adhesion molecule-1 levels in acute rheumatic fever

In order to determine the role of soluble intercellular adhesion molecule-1 (sICAM-1) in the pathogenesis and course of acute rheumatic fever (ARF), serum levels of ICAM-1 were measured in 30 patients at onset of ARF, in remission and during inactive periods of the disease (group 1), in 20 patients who had had ARF at least a year beforehand and had no evidence of exacerbation of the disease (group 2) and in 20 healthy children. Serum levels of sICAM-1 were increased in group 1, peaking in the active phase of the disease and declining during remission to the inactive phase of the disease when they were still significantly higher than in the controls, despite their ESR and fibrinogen levels having fallen to normal limits. The levels in group 2 were similar to those in the healthy controls. We consider that ICAM-1 plays a role in the pathogenesis of ARF and that improvement of ARF might best be determined by serum sICAM-1 levels, even when clinical and other laboratory test results have returned to normal, but additional studies are needed to clarify this hypothesis.