You can dance if you want to: A case of Sydenham's chorea

Lubberdink, Ashley L.; Sharif, Sameer; Pardhan, Kaif

doi:10.1016/j.ajem.2019.158414

Cited by 2 publications

(3 citation statements)

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Section: Resultsmentioning

confidence: 99%

“…We identified 1479 patients with IPD (median [IQR] age at onset, 10 [8-13] years in 1354 patients; 985 of 1426 [69.1%] female and 441 of 1426 [30.9%] male) were identified from 307 articles 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , ...…”

Section: Resultsmentioning

confidence: 99%

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Treatments and Outcomes Among Patients with Sydenham Chorea

Eyre,

Thomas,

Ferrarin

et al. 2024

JAMA Netw Open

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ImportanceSydenham chorea is the most common acquired chorea of childhood worldwide; however, treatment is limited by a lack of high-quality evidence.ObjectivesTo evaluate historical changes in the clinical characteristics of Sydenham chorea and identify clinical and treatment factors at disease onset associated with chorea duration, relapsing disease course, and functional outcome.Data SourcesThe systematic search for this meta-analysis was conducted in PubMed, Embase, CINAHL, Cochrane Library, and LILACS databases and registers of clinical trials from inception to November 1, 2022 (search terms: [Sydenham OR Sydenham’s OR rheumatic OR minor] AND chorea).Study SelectionPublished articles that included patients with a final diagnosis of Sydenham chorea (in selected languages).Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Individual patient data on clinical characteristics, treatments, chorea duration, relapse, and final outcome were extracted. Data from patients in the modern era (1945 through 2022) were entered into multivariable models and stratified by corticosteroid duration for survival analysis of chorea duration.Main Outcomes and MeasuresThe planned study outcomes were chorea duration at onset, monophasic course (absence of relapse after ≥24 months), and functional outcome (poor: modified Rankin Scale score 2-6 or persisting chorea, psychiatric, or behavioral symptoms at final follow-up after ≥6 months; good: modified Rankin Scale score 0-1 and no chorea, psychiatric, or behavioral symptoms at final follow-up).ResultsIn total, 1479 patients were included (from 307 articles), 1325 since 1945 (median [IQR] age at onset, 10 [8-13] years; 875 of 1272 female [68.8%]). Immunotherapy was associated with shorter chorea duration (hazard ratio for chorea resolution, 1.51 [95% CI, 1.05-2.19]; P = .03). The median chorea duration in patients receiving 1 or more months of corticosteroids was 1.2 months (95% CI, 1.2-2.0) vs 2.8 months (95% CI, 2.0-3.0) for patients receiving none (P = .004). Treatment factors associated with monophasic disease course were antibiotics (odds ratio [OR] for relapse, 0.28 [95% CI, 0.09-0.85]; P = .02), corticosteroids (OR, 0.32 [95% CI, 0.15-0.67]; P = .003), and sodium valproate (OR, 0.33 [95% CI, 0.15-0.71]; P = .004). Patients receiving at least 1 month of corticosteroids had significantly lower odds of relapsing course (OR, 0.10 [95% CI, 0.04-0.25]; P &lt; .001). No treatment factor was associated with good functional outcome.Conclusions and RelevanceIn this meta-analysis of treatments and outcomes in patients with Sydenham chorea, immunotherapy, in particular corticosteroid treatment, was associated with faster resolution of chorea. Antibiotics, corticosteroids and sodium valproate were associated with a monophasic disease course. This synthesis of retrospective data should support the development of evidence-based treatment guidelines for patients with Sydenham chorea.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Treatments and Outcomes Among Patients with Sydenham Chorea

Eyre,

Thomas,

Ferrarin

et al. 2024

JAMA Netw Open

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“…Later, the choreic movements become more obvious and typically more generalized (16) . Most commonly, changes include emotional lability and aggression, impulsivity, and obsessive-compulsive behaviour (16,17) . Behavioural changes may dominate the clinical picture more than a movement disorder;one of our patients had symptoms for almost 45 days without any complaint of involuntary movement.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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Objective: Our aim is to evaluate patients being referred with an initial diagnosis of chorea according to their clinical, laboratory features and final diagnoses while emphasizing cardiological findings of patients with Sydenham chorea. Method: Children aged 4-18 years who were referred to Okmeydanı Research and Training Hospital Pediatric Neurology department with an initial diagnosis of acute, subacute chorea between January 2017-January 2020 were retrospectively included. Chronic chorea and diseases associated with chronic chorea were excluded from the study. Data concerning clinical, laboratory features, cardiological findings, etiologies, treatments, recurrence rates and follow-ups of patients were recorded. Descriptive statistical analysis were performed using SPSS 21.0. Results: Fifteen patients has been referred with the initial diagnosis of chorea. Mean age of the patients was 11.5±2.2 years. Ten (67%) patients were females, 5 (33%) patients were male. After admission, 8 (54%) patients were diagnosed with Sydenham chorea, and 2 (13%) patients with recurrent Sydenham chorea. During physical examination, 5 (33%) patients did not have chorea, and 3 cases had tic disorder. Out of 8 patients with new diagnosis of Sydenham chorea, 3 (37.5%) patients had subclinical carditis, and 5 (62.5%) patients clinical carditis. Chorea had been treated with one of haloperidol/biperiden, valproic acid and prednisolon options. The treatment of 6 patients attending regular follow-up visits was stopped 2-6 months later. Chorea of two patients recurred during our follow-up, and one of our newly diagnosed Sydenham chorea patients had been recognized as antiphospholipid antibody syndrome after recurrence. Conclusion: Sydenham chorea is the most common cause of acquired chorea in childhood. Most of the time it is self limiting. Differential diagnosis of chorea must be kept in mind especially when there is a recurrence.

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You can dance if you want to: A case of Sydenham's chorea

Cited by 2 publications

References 10 publications

Treatments and Outcomes Among Patients with Sydenham Chorea

Treatments and Outcomes Among Patients with Sydenham Chorea

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

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