Corticosteroid treatment in patients with Sydenham’s chorea

Treatment of Sydenham’s Chorea: A Review of the Current Evidence

“…For example, reports varied on whether they provided the time to improvement of symptoms (10 out of 44),19,25,27,30,35–38,42,55 the time to full remission of symptoms (two out of 44),21,28 or both (13 out of 44) 20,22–24,26,32,33,35,41,44–46,52,53. Nine out of 38 studies reviewed improvement in a chorea score at fixed weekly, monthly, or yearly intervals, rather than reporting the time to an observed improvement or recovery 29,40,47–51,54,56.…”

“…Nine out of 38 studies reviewed improvement in a chorea score at fixed weekly, monthly, or yearly intervals, rather than reporting the time to an observed improvement or recovery 29,40,47–51,54,56. Twenty-eight out of 44 reported the total length of time treatment was provided 20,22–30,32–36,38,44–46,48–56…”

“…Sulfa drugs are commonly used for those individuals with a penicillin allergy. In the reviewed literature, only four papers (11 patients) reported throat culture results at the time of diagnosis (five positive, six negative) 28,32,34,45,52…”

An update on the treatment of Sydenham’s chorea: the evidence for established and evolving interventions

“…Improvements in symptoms with corticosteroids were reported in three studies but the group sizes were small (n ¼ 48 patients) and conducted without controls [Barash et al 2005;Teixeira et al 2005;Green, 1978]. Twenty two children treated with steroids were compared with 15 placebo controls in a randomized, double-blind, parallel study [Paz et al 2006].…”

Chorea

“…In the author's practice, intravenous methylprednisolone is reserved for patients with persistent disabling chorea refractory to anti-choreic agents. We have reported that 25 mg/kg per day in children and 1 g/day in adults of methylprednisolone for five days followed by 1 mg/kg per day of prednisone is an effective and well-tolerated treatment for patients with SC refractory to conventional treatment with anti-choreic drugs and penicillin Teixeira, Maia and Cardoso, 2005c;Barash, Margalith and Matitiau, 2005). Finally, a recent double-blind study showed that oral prednisone (initial dosage of 1 mg/ kg/day, gradually decreased depending on the clinical response) is faster than placebo in inducing remission of chorea (Paz, Silva and Marques-Dias, 2006).…”