Combined Salicylate, Corticotropin and Corticosteroid Therapy in Acute Monocyclic Rheumatic Pancarditis

A Preliminary Report

¹ Clinical Assistant Professor of Medicine and Clinical Instructor of Cardiology, University of Miami School of Medicine.

1. The relative merits of aspirin, corticotropin and corticosteroids in the acute phase of rheumatic carditis has been the subject of numerous reports over the past decade, but the supremacy of any of these agents in terms of disease response has not been established.

2. It is generally agreed that any one of these agents, if administered in sufficient dosage, will suppress the manifestations of the inflammatory process of acute rheumatic fever.

3. It is postulated that a combination of these agents may have additive therapeutic value; hence, suppression of acute rheumatic activity may be accomplished with an appreciably smaller dosage of each with a consequent reduction of both toxic and untoward reactions.

4. A case of acute monocyclic rheumatic pancarditis successfully treated by the simultaneous administration of salicylates, corticotropin and corticosteroids is presented. It is believed this concept bears further exploration; however, no claim of originality is made for the treatment presented, nor is there the slightest intent to perpetuate a specific protocol.

5. Viewed in the light of our present knowledge of the natural course of rheumatic disease, and the purely suppressive role ascribed to these drugs, the rationale of inflexible, high dosage, short-term therapeutic protocols is questioned (Fig. 3).