[P3-83] A Natural History of Syndenham’s Chorea in Filipino Children: A Case Series
[Introduction]
To present a case series of Filipino children who presented with chorea and to describe the natural history of Sydenham’s chorea (SC).
SC is a late manifestation of acute rheumatic fever (ARF) and can occur several months after group A β-hemolytic Streptococcus infection. It is characterized by involuntary choreiform movements including facial grimacing, hypotonia, muscle weakness, gait disturbance, difficulty in writing and speaking.
[Methodology]
Five patients with SC consulted from 2014-2015. SC was diagnosed according to the 1992 revision of the Jones criteria. Patient medical histories, physical, neurological examinations and Anti-streptolysin O (ASO), erythrocyte sedimentation rate (ESR), CRP, 2-D echo were obtained. They were followed up at 2 weeks and one month after. ARF prophylaxis with benzathine G penicillin every 21 days was started.
[Results]
Three (60%) males and 2 (40%) females and the average age at onset was 9.6 years (range 8-11 years). Five (100%) had history of respiratory tract and throat infections within 2-3 months. Three (60%) showed elevated ASO level and 5 (100%) had. Four (80%) have severe chorea, 2 (20%) generalized chorea, 3 (60%) hemichorea. Five (100%) have speech disorder, 2 (20%) behavioral changes, and 2 (40%) muscle weakness. Five (100%) manifested with classic neurologic signs. Four (80%) recovered within 2-3 months. Mean follow-up period was 4.5 months. One (20%) had recurrence.
[Conclusion]
SC is a post-streptococcal autoimmune disease and it is the most common cause of chorea during childhood in the Philippines. Educating regarding the prevention of rheumatic fever by the use of long-term penicillin may lessen the burden of the choreiform movements in children.
To present a case series of Filipino children who presented with chorea and to describe the natural history of Sydenham’s chorea (SC).
SC is a late manifestation of acute rheumatic fever (ARF) and can occur several months after group A β-hemolytic Streptococcus infection. It is characterized by involuntary choreiform movements including facial grimacing, hypotonia, muscle weakness, gait disturbance, difficulty in writing and speaking.
[Methodology]
Five patients with SC consulted from 2014-2015. SC was diagnosed according to the 1992 revision of the Jones criteria. Patient medical histories, physical, neurological examinations and Anti-streptolysin O (ASO), erythrocyte sedimentation rate (ESR), CRP, 2-D echo were obtained. They were followed up at 2 weeks and one month after. ARF prophylaxis with benzathine G penicillin every 21 days was started.
[Results]
Three (60%) males and 2 (40%) females and the average age at onset was 9.6 years (range 8-11 years). Five (100%) had history of respiratory tract and throat infections within 2-3 months. Three (60%) showed elevated ASO level and 5 (100%) had. Four (80%) have severe chorea, 2 (20%) generalized chorea, 3 (60%) hemichorea. Five (100%) have speech disorder, 2 (20%) behavioral changes, and 2 (40%) muscle weakness. Five (100%) manifested with classic neurologic signs. Four (80%) recovered within 2-3 months. Mean follow-up period was 4.5 months. One (20%) had recurrence.
[Conclusion]
SC is a post-streptococcal autoimmune disease and it is the most common cause of chorea during childhood in the Philippines. Educating regarding the prevention of rheumatic fever by the use of long-term penicillin may lessen the burden of the choreiform movements in children.