Related Experiment Videos
Lupus-associated chorea in childhood
Insights
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.
Abstract:
Chorea associated with systemic lupus erythematosus (SLE) has been reported in only 28 patients. The clinical and laboratory features of these cases are reviewed here, along with those of a 7-year-old boy who, we believe, represents the youngest child reported to date. In approximately half of these 29 individuals, most of whom were children, chorea preceded other manifestations of SLE. The age range and clinical characteristics of lupus-associated chorea were not appreciably different from those of Sydenham's chorea and most of the patients in whom chorea developed before other manifestations of SLE were initially assumed to have Sydenham's chorea. Systemic lupus erythematosus should especially be considered if chorea begins in the older child or is associated with a persistently elevated erythrocyte sedimentation rate.