Sydenham Chorea On Indonesian 10 Years Old Boy Caused By Rheumatic Heart Disease : Case Report And Literature Review
Article Sidebar
Main Article Content
Abstract
Sydenham's chorea (SC) is one of the manifestations of rheumatic fever, and is the most common cause of chorea in childrens. Sydenham chorea is characterized by involuntary movements such as jerking of the arms, legs, and face. The following case is a 10-year-old boy with complaints of moving his right arm and leg on its own. On physical examination, there was a grade 4/5 systolic murmur at ICS 5 2 cm lateral to the left MCL blowing radiating to the left arm. ASTO examination there is an increase. CT scan of the head without contrast showed no abnormalities. The results of echocardiography showed severe mitral regurgitation. The patient was diagnosed with Sydenham Chorea and Rheumatic Heart Disease. The patient refused hospitalization and was treated as an outpatient with given therapy erythromycin 250 mg four times daily for 10 days followed by a twice daily dose for the next two months, symptomatic haloperidol 1 mg and trihexyphenidyl 0.5 mg twice a day, aspirin 300 mg four times a day for one month. From this treatment, the complaints improved slowly, and the chorea disappeared within 10 days of the start of treatment.
Downloads
Article Details
Copyright (c) 2022 Laily Irfana, M. Perdana Airlangga, Nina Devi Indrawati, M. Hanun Mahyuddin
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Boersma NA, Schippers H, Kuijpers T, Heidema J. Successful treatment of Sydenham’s chorea with intravenous immunoglobulin. BMJ Case Rep. 2016 Feb;2016.
Sie J, Sumada IK. The Case Report: Chorea Sydenham In Young Adult Female As Symptom Of Rheumatic Fever. Callosum Neurol. 2020;3(1):29–35.
Cunningham MW. Streptococcus and rheumatic fever. Curr Opin Rheumatol. 2012 Jul;24(4):408–16.
Fusco C, Spagnoli C. Corticosteroid treatment in Sydenham’s chorea. Eur J Paediatr Neurol EJPN Off J Eur Paediatr Neurol Soc. 2018 Mar;22(2):327–31.
Gregorowski C, Lochner C, Martin L, Simmons C, Kidd M, Walker K, et al. Neuropsychological manifestations in children with Sydenham’s chorea after adjunct intravenous immunoglobulin and standard treatment. Metab Brain Dis. 2016 Feb;31(1):205–12.
Favaretto E, Gortani G, Simonini G, Pastore S, Di Mascio A, Cimaz R, et al. Preliminary data on prednisone effectiveness in children with Sydenham chorea. Eur J Pediatr. 2020 Jun;179(6):993–7.
Direk M, Epcacan S, Epcacan Z, Yildirim DD, Okuyaz C. Efficacy of levetiracetam in the treatment of Sydenham chorea. Pediatr Int. 2020 Nov;62(11):1264–8.
Dean SL, Singer HS. Treatment of Sydenham’s Chorea: A Review of the Current Evidence. Tremor Other Hyperkinet Mov (N Y). 2017;7:456.
OLIVER J, PIERSE N, BAKER MG. Estimating rheumatic fever incidence in New Zealand using multiple data sources. Epidemiol Infect [Internet]. 2014/03/06. 2015;143(1):167–77. Available from: https://www.cambridge.org/core/article/estimating-rheumatic-fever-incidence-in-new-zealand-using-multiple-data-sources/BF171414DC12E3A5032B537A9FA3C364
Lardhi AA. Sydenham chorea in a 5-year-old Saudi patient. Neurosciences (Riyadh). 2014 Jul;19(3):236–7.
Ismail P, Sobur CS, Olyvia C. RECURRENT RHEUMATIC FEVER. Indones J Int Law [Internet]. 2017;14(2):273–5. Available from: https://www.neliti.com/id/publications/65557/indonesia-and-the-law-of-the-sea
Teixeira AL, Vasconcelos LP, Nunes M do CP, Singer H. Sydenham’s chorea: from pathophysiology to therapeutics. Expert Rev Neurother [Internet]. 2021;21(8):913–22. Available from: https://doi.org/10.1080/14737175.2021.1965883
Cunningham MW, Cox CJ. Autoimmunity against dopamine receptors in neuropsychiatric and movement disorders: a review of Sydenham chorea and beyond. Acta Physiol (Oxf). 2016 Jan;216(1):90–100.
Cunningham MW. Molecular Mimicry, Autoimmunity, and Infection: The Cross-Reactive Antigens of Group A Streptococci and their Sequelae. Microbiol Spectr. 2019 Jul;7(4).
Cox CJ, Sharma M, Leckman JF, Zuccolo J, Zuccolo A, Kovoor A, et al. Brain human monoclonal autoantibody from sydenham chorea targets dopaminergic neurons in transgenic mice and signals dopamine D2 receptor: implications in human disease. J Immunol. 2013 Dec;191(11):5524–41.
Teixeira Jr. AL, Maia DP, Cardoso F. UFMG Sydenham’s chorea rating scale (USCRS): Reliability and consistency. Mov Disord [Internet]. 2005 May 1;20(5):585–91. Available from: https://doi.org/10.1002/mds.20377
Vasconcelos LPB, Vasconcelos MC, Nunes MDCP, Teixeira AL. Sydenham’s chorea: an update on pathophysiology, clinical features and management. Expert Opin Orphan Drugs [Internet]. 2019 Nov 2;7(11):501–11. Available from: https://doi.org/10.1080/21678707.2019.1684259
Dileepan T, Smith ED, Knowland D, Hsu M, Platt M, Bittner-Eddy P, et al. Group A Streptococcus intranasal infection promotes CNS infiltration by streptococcal-specific Th17 cells. J Clin Invest. 2016 Jan;126(1):303–17.
McAfoose J, Baune BT. Evidence for a cytokine model of cognitive function. Neurosci Biobehav Rev. 2009 Mar;33(3):355–66.
Gray LA, D’Antoine HA, Tong SYC, McKinnon M, Bessarab D, Brown N, et al. Genome-Wide Analysis of Genetic Risk Factors for Rheumatic Heart Disease in Aboriginal Australians Provides Support for Pathogenic Molecular Mimicry. J Infect Dis. 2017 Dec;216(11):1460–70.
Gewitz MH, Baltimore RS, Tani LY, Sable CA, Shulman ST, Carapetis J, et al. Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography. Circulation [Internet]. 2015 May 19;131(20):1806–18. Available from: https://doi.org/10.1161/CIR.0000000000000205
de Teixeira AL, Cardoso F, Maia DP, Sacramento DR, Mota C de CC, Meira ZMA, et al. Frequency and significance of vocalizations in Sydenham’s chorea. Parkinsonism Relat Disord. 2009 Jan;15(1):62–3.
Punukollu M, Mushet N, Linney M, Hennessy C, Morton M. Neuropsychiatric manifestations of Sydenham’s chorea: a systematic review. Dev Med Child Neurol. 2016 Jan;58(1):16–28.
Harsányi E, Moreira J, Kummer A, Meira ZMA, Cardoso F, Teixeira AL. Language Impairment in Adolescents With Sydenham Chorea. Pediatr Neurol. 2015 Nov;53(5):412–6.
Carapetis JR, Beaton A, Cunningham MW, Guilherme L, Karthikeyan G, Mayosi BM, et al. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Prim. 2016 Jan;2:15084.
Genel F, Arslanoglu S, Uran N, Saylan B. Sydenham’s chorea: clinical findings and comparison of the efficacies of sodium valproate and carbamazepine regimens. Brain Dev. 2002 Mar;24(2):73–6.
Gurkas E, Karalok ZS, Taskin BD, Aydogmus U, Guven A, Degerliyurt A, et al. Predictors of recurrence in Sydenham’s chorea: Clinical observation from a single center. Brain Dev. 2016 Oct;38(9):827–34.
Cardoso F, Vargas AP, Oliveira LD, Guerra AA, Amaral S V. Persistent Sydenham’s chorea. Mov Disord. 1999 Sep;14(5):805–7.