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[Chorea associated with antiphospholipid antibodies].

T Shimomura1, S Takahashi, S Takahashi

  • 1Department of Neurology, Iwate Prefectural Central Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|September 1, 1992
PubMed
Summary

Antiphospholipid antibodies may cause chorea, a movement disorder. This case highlights the need to test for these antibodies in unexplained chorea, even without typical antiphospholipid antibody syndrome symptoms.

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Area of Science:

  • Neurology
  • Immunology
  • Rheumatology

Background:

  • Chorea is a hyperkinetic movement disorder characterized by involuntary, irregular, and purposeless movements.
  • Antiphospholipid antibody syndrome (APS) is an autoimmune disorder associated with a predisposition to thrombosis and pregnancy morbidity.

Observation:

  • A 21-year-old woman presented with progressive chorea affecting all four extremities, face, mouth, and tongue.
  • She had no prior history of neurological, psychiatric, rheumatological, or vascular diseases.
  • Neurological examination revealed significant choreiform movements, difficulty with speech and swallowing, and unsteady gait.

Findings:

  • Laboratory tests revealed the presence of antinuclear antibodies and anticardiolipin antibodies (positive VDRL, negative syphilis tests).

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  • Despite serological evidence of antiphospholipid antibodies, the patient lacked classical clinical features of APS, such as recurrent pregnancy loss, thrombosis, or thrombocytopenia.
  • Brain imaging (CT, MRI, SPECT) and cerebral angiography were normal, ruling out structural or vascular causes.

    • Implications:

    • This case suggests a potential association between antiphospholipid antibodies and unexplained chorea, even in the absence of overt clinical APS.
    • It underscores the importance of screening for antiphospholipid antibodies in patients presenting with idiopathic chorea.
    • Further research is warranted to elucidate the mechanisms linking antiphospholipid antibodies to chorea and to establish diagnostic guidelines.