Clinical, laboratory and instrumental characteristics of children with sydenham’s chorea

Abstract


Sydenham's chorea (SC) is a major clinical criterion in acute rheumatic fever (RF). SC is a late neurological manifestation of acute rheumatic fever which occurs 1 to 6 months after pharyngeal infection with group A betahemolytic streptococci. SC is characterized by clinical symptoms: involuntary hyperkinetic movements, muscular hypotonia, hyperreflexia, gait disturbance, emotional lability. Objective: The aim of the study was to identify frequency, clinical manifestations and the treatment of SC. The study included 56 children 4-17 years old, who were hospitalized in the Morozovskaya children’s clinical city hospital in 2001-2015 with RF. Clinical history, laboratory and instrumental methods (electrocardiography, transthoracic echocardiogram, cranial computed tomography scan and/or magnetic resonance imaging, electroencephalography, electroneuromyography). The study revealed frequent errors (66%) in RF diagnosis before hospitalization. Besides chorea, the clinical manifestations of RF were: carditis (89,3%), arthritis (46,4%), erythema marginatum (10,7%), subcutaneous nodule (1,8%). The peculiarity of our study washighfrequency of chorea (42,9%). Isolated chorea wasseen in 12,5%, mixed chorea - in 30,4% of SC. The clinical manifestations of chorea were typical. The nervous system lesion most often occured in children with a neurological history (p < 0,05). The clinical or laboratory evidence of streptococcal infection were seldom found (p = 0,02) in patients withchorea (45,8%) compared with patients without chorea symptoms (69%). RF issue requires attention from the medical community. SC, especially isolated chorea (29%), is the most challenging manifestation of RF for the differential diagnosis.Chronic rheumatic heart disease can be developed even in patients with isolated chorea (12,5%). In the treatment of SC in addition antibiotics and drugs which affect domamine and GABA metabolism, glucocorticoids (Prednisolone) are needed.

M G Kantemirova

kantemirova60@mail.ru
RUDN University
Moscow, Russia

Morozovskaya children’s city clinical hospital

Yu Yu Novikova

8newyu8@mail.ru
RUDN University
Moscow, Russia

O A Korovina

o.korovina2013@yandex.ru
RUDN University
Moscow, Russia

Morozovskaya children’s city clinical hospital

I M Drozdova

Irina.drozdova@mail.ru
Morozovskaya children’s city clinical hospital
Moscow, Russia

E A Degtyareva

dib6@yandex.ru
RUDN University
Moscow, Russia

D Yu Ovsyannikov

mdovsyannikov@yahoo.com
RUDN University
Moscow, Russia

Morozovskaya children’s city clinical hospital

I E Koltunov

info@mdgkb.mosgorzdrav.ru
RUDN University
Moscow, Russia

Morozovskaya children’s city clinical hospital

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Copyright (c) 2017 Кантемирова М.Г., Новикова Ю.Ю., Коровина О.А., Дроздова И.М., Дегтярева Е.А., Овсянников Д.Ю., Колтунов И.Е.

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