الفهرس 
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Abstract
The subjects of the present study comprised 40 children with RHD, there were selected from the Pediatric Department and Out - Patient Clinic in Mansoura University Hospital from the period of August 1996 to April 1997 . They were divided into 2 main groups : active RHD group; which include 20 children : 13 were males and 7 were females aged 7- 15 years (mean age 11. 2 ± 2.1). This group subdivided into 2 sub- groups: patients with carditis (13 patients) and patients with carditis and arthritis (7 patients) . The chronic non - active RHD group included 20 children, 6 were males and 14 were females aged 7 -15 (mean age 11.3 ± 2.5 ) . Control group comprised from 20 normal children of matched age and sex (mean age 11.2 ± 2.3) .All cases as well as control subjects, were subjected to: - Thorough histroy taking, clinical evaluation . - Laboratory investigations including ESR, CRP, ASO . - Radiological and echocardiographic examination . - Determination ofIL-I a, HLA-DR and ICAM-I . - Our results can be summerized in the following : 1- Intercellular adhesion molecule (ICAM-l) : In our study, we found that there was a significant increse in ICAM-I expression in active RHD comparing with the control group, while there was no significant difference have been found between active and non-active RHD groups. But the activity alone does not reflect any increase in ICAM-I when we compare non-active with active patients. This may be due to the overexpression of ICAM-I from the activated endothelial cells during both the acute and chronic inflammatory process of rheumatic fever. Also we