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Childhood/adolescent Sydenham's chorea in the UK and Ireland: a BPSU/CAPSS surveillance study

Eva Louise Wooding1,2, Michael John Stuart Morton3, Ming Lim4,5

  • 1Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Archives of Disease in Childhood
|May 24, 2023
PubMed

Insights

Sydenham's chorea (SC) is rare but present in the UK and Ireland, impacting children's functioning. Paediatricians and child psychiatrists must recognize its symptoms, including emotional and behavioral issues, for timely diagnosis and management.

Area of Science:

  • Pediatric Neurology
  • Child Psychiatry
  • Epidemiology

Background:

  • Sydenham's chorea (SC) is a rare autoimmune disorder following streptococcal infection.
  • Understanding the current incidence and presentation of SC in children is crucial for effective healthcare planning.

Purpose of the Study:

  • To conduct the first prospective surveillance study of Sydenham's chorea (SC) in the UK and Ireland.
  • To determine the incidence, presentation, and management of SC in children aged 0-16 years within paediatric and child psychiatric services.

Main Methods:

  • Prospective surveillance utilizing the British Paediatric Surveillance Unit (BPSU) for paediatric reports.
  • Complementary surveillance through the Child and Adolescent Psychiatry Surveillance System (CAPSS) for psychiatric reports.
  • Data collection over 24 months (BPSU) and 18 months (CAPSS) from November 2018.

Main Results:

  • 43 eligible cases of SC reported via BPSU over 24 months, yielding an incidence rate of 0.16 per 100,000 children/year.
  • No SC cases reported via CAPSS, despite over 75% of BPSU cases presenting with emotional/behavioral symptoms.
  • Antibiotics were common (almost all cases), with 22% receiving immunomodulatory treatment.

Conclusions:

  • Sydenham's chorea, though rare, continues to occur in the UK and Ireland.
  • The condition significantly impacts children's functioning, often presenting with emotional and behavioral symptoms.
  • Enhanced consensus on SC identification, diagnosis, and management across child health settings is needed.
Abstract

Keywords:
cardiologyepidemiologymicrobiologyneurologypaediatrics

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