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Lupus-associated chorea in childhood
American Journal of Diseases of Children (1960)
|October 1, 1977
Summary
Systemic lupus erythematosus (SLE) can cause chorea, a neurological disorder, particularly in children. Early recognition is key, as chorea may precede other SLE symptoms, mimicking Sydenham's chorea.
Area of Science:
- Neurology
- Rheumatology
- Pediatrics
Background:
- Chorea is a rare neurological manifestation of Systemic Lupus Erythematosus (SLE).
- Reported cases of SLE-associated chorea are limited, with only 28 previously documented.
- This review includes a case of a 7-year-old, potentially the youngest reported patient.
Observation:
- In nearly half of the 29 reviewed cases, chorea was the initial presenting symptom of SLE.
- The clinical presentation and age distribution of lupus-associated chorea closely resemble Sydenham's chorea.
- Patients presenting with chorea before other SLE symptoms were often initially misdiagnosed as having Sydenham's chorea.
Findings:
- Systemic lupus erythematosus (SLE) should be considered in cases of chorea, especially in older children.
- A persistently elevated erythrocyte sedimentation rate in conjunction with chorea warrants investigation for SLE.
- Lupus-associated chorea shares clinical and demographic features with Sydenham's chorea, complicating early diagnosis.
Implications:
- Highlights the importance of considering SLE in the differential diagnosis of chorea, particularly when it precedes other systemic signs.
- Suggests that earlier diagnostic consideration of SLE in children presenting with chorea could improve patient outcomes.
- Emphasizes the need for increased awareness among clinicians regarding the neurological manifestations of SLE in pediatric populations.