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Sydenham's chorea in Jerusalem: still present.

Isabelle Korn-Lubetzki1, Abraham Brand

  • 1Neurological Service, Bikur Cholim Hospital, Jerusalem, Israel. ikl@md.huji.ac.il

The Israel Medical Association Journal : IMAJ
|August 26, 2004
PubMed
Summary

Sydenham's chorea (SC) remains prevalent in Jerusalem's pediatric population, with a significant recurrence rate years after initial diagnosis. Early recognition and treatment are crucial for managing this rheumatic fever manifestation.

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Area of Science:

  • Pediatrics
  • Neurology
  • Rheumatology

Background:

  • Sydenham's chorea (SC), a key indicator of rheumatic fever, has seen declining incidence in developed nations but persists globally.
  • Outbreaks of SC continue to be documented worldwide, necessitating ongoing surveillance and characterization.

Purpose of the Study:

  • To characterize the clinical presentation and outcomes of Sydenham's chorea patients in the Jerusalem region.
  • To assess the prevalence, associated features, and recurrence patterns of SC in a defined pediatric cohort.

Main Methods:

  • A prospective study of rheumatic fever and SC was conducted from 1985 to 2002, adhering to the revised Jones criteria.
  • Patients were monitored for 1-14 years, with recurrence defined by new signs lasting over 24 hours and separated by at least two months.
  • Etiologies other than rheumatic fever were excluded, and cardiac involvement was assessed using echocardiography.

Main Results:

  • Of 180 children with rheumatic fever, 24 (13.3%) were diagnosed with SC, predominantly from large Ashkenazi families.
  • Chorea was associated with other rheumatic fever signs in 79% of cases; cardiac involvement was detected in 75% via echocardiography.
  • Recurrent SC episodes occurred in 42% of patients, sometimes years after the initial event, with chorea being the sole sign at recurrence in most cases.

Conclusions:

  • Sydenham's chorea continues to be a relevant condition in the pediatric population of Jerusalem.
  • The potential for late recurrence of SC underscores the importance of long-term follow-up and management.
  • Timely diagnosis and appropriate treatment are essential for patients with Sydenham's chorea to prevent complications.

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