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Published on: April 29, 2007
Sydenham's chorea: not gone and not forgotten
Daniel J Bonthius1, Bahri Karacay
1Department of Pediatrics, College of Medicine, University of Iowa, Iowa City 52242, USA.
Insights
Sydenham's chorea, a rheumatic fever complication in children, causes movement and psychiatric issues. Antibiotic prophylaxis and immune therapies targeting streptococcal infections and basal ganglia antibodies are key treatments.
Area of Science:
- Neurology
- Pediatrics
- Rheumatology
Background:
- Sydenham's chorea is a neurological disorder linked to rheumatic fever.
- It presents with movement abnormalities and psychiatric symptoms in children globally.
- It can also indicate severe cardiac involvement (carditis).
Observation:
- The condition is triggered by streptococcal pharyngitis.
- Its pathogenesis involves anti-basal ganglia antibodies.
- It may be part of a broader spectrum of streptococcal-induced neuropsychiatric syndromes.
Findings:
- Antibiotic prophylaxis is crucial for preventing recurrent streptococcal infections.
- Therapies aimed at immune modulation or restoring basal ganglia neurotransmitter balance show potential.
- Sydenham's chorea is recognized as a significant pediatric neurological concern.
Implications:
- Early diagnosis and management are vital to prevent long-term complications like carditis.
- Understanding the autoimmune basis may lead to novel therapeutic strategies.
- This highlights the importance of addressing streptococcal infections in pediatric populations.
Abstract:
Sydenham's chorea is an ancient disease that continues to afflict large numbers of children throughout the world. A major manifestation of rheumatic fever, Sydenham's chorea is commonly manifested by movement disorder and psychiatric problems, and also may be a marker for a life-threatening carditis. Because Sydenham's chorea is triggered by streptococcal pharyngitis, the most important component of its therapy is antibiotic prophylaxis against further streptococcal infections. Because the pathogenesis of Sydenham's chorea includes the production of anti-basal ganglia antibodies, therapies that modulate immune function or that restore neurotransmitter balance within the basal ganglia may be effective for Sydenham's chorea. Recent reports have suggested that Sydenham's chorea may be part of a spectrum of neuropsychiatric syndromes induced by streptococcal infection.
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