Recognizing red flags for alternative diagnoses in pediatric chorea beyond Sydenham's

Area of Science:

• Pediatric Neurology
• Movement Disorders
• Rheumatology

Background:

• Chorea is a prevalent pediatric movement disorder requiring accurate etiological diagnosis.
• Identifying treatable causes of chorea improves patient outcomes and quality of life.

Purpose of the Study:

• To characterize the clinical, demographic, and epidemiological features of pediatric and adolescent chorea patients.
• To identify key diagnostic indicators for various chorea etiologies.

Main Methods:

• Retrospective cross-sectional study.
• Analysis of 81 pediatric patients diagnosed with chorea.
• Data collected from a tertiary hospital in Bogotá, Colombia (2008-2022).

Main Results:

• Rheumatic fever (Sydenham's chorea) was the most common cause (50.6%), followed by vascular chorea (29.3%) and lupus (11.1%).
• Patients with Sydenham's chorea were significantly older (10.36 ± 3.41 years) than those with other etiologies (8.29 ± 5.16 years).
• Psychiatric symptoms showed a positive correlation with age (OR 1.14 per year), irrespective of etiology.

Conclusions:

• Younger age, additional movement disorders, or neurological findings may suggest an etiology other than Sydenham's chorea.
• Neuropsychiatric manifestations are common in pediatric chorea and correlate with patient age.
• Timely diagnosis and etiological identification are crucial for managing pediatric chorea.