Corticosteroid Treatment in Sydenham Chorea: A 27-Year Tertiary Referral Center Experience
TL;DR: In this paper , the effectiveness of corticosteroid therapy for children suffering from Sydenham chorea (SC) was investigated, and the authors found that the duration of chorea was significantly shorter in patients treated with corticostosteroids in comparison to those receiving symptomatic treatment.
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Abstract: Objective: The purpose of this study was to investigate the effectiveness of corticosteroid therapy for children suffering from Sydenham chorea (SC). Methods: The design of the study was observational, retrospective and conducted at the single center of the Rheumatology Unit of Policlinic Hospital of Milan, Italy, from May 1995 to May 2022. All data about the patients were collected from medical records. Results: From a total of 59 patients enrolled in the study (44 females and 15 males; median age 9.3 years, range 7.4–10.6 years), 49 were eligible for primary outcome analysis (10 patients were excluded due to incomplete data). Overall, 75% of patients received steroid therapy, while the remaining cases were treated with symptomatic drugs, including neuroleptics and antiseizure drugs. We found that the duration of chorea was significantly shorter in patients treated with corticosteroids in comparison to those receiving symptomatic treatment (median time: 31 vs. 41 days, p = 0.023). Additionally, patients with arthritis at the onset of the disease had a longer duration of chorea than those without arthritis (median time 90.5 vs. 39 days, p = 0.02). We also found that chorea recurred in 12% of the patients and seemed to be linked to a younger age at onset (p = 0.01). Conclusions: The study suggests that corticosteroid therapy can lead to a faster resolution of SC when compared to neuroleptics and antiseizure drugs treatment.
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Sydenham chorea in the top end of Australia's Northern Territory: A 20‐year retrospective case series
Tasmyn Soller,K. Roberts,Bianca F Middleton,Anna P. Ralph +3 more
TL;DR: A 20-year retrospective case series in Northern Australia's Northern Territory found 110 Sydenham chorea cases, predominantly in First Nations children (99%), with 78% having rheumatic heart disease and variable treatment approaches.
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The Role of Levetiracetam and Prednisolone in the Treatment of Sydenham's Chorea.
M. Douvoyiannis,Kalli Fautsch,James Miles +2 more
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Treatments and Outcomes Among Patients with Sydenham Chorea
Michael Eyre,Terrence Thomas,Emanuela Ferrarin,Sonia Khamis,Sameer M. Zuberi,Adrian Sie,Tamsin Newlove-Delgado,Michael Morton,Erika Molteni,Russell C Dale,Ming Lim,Margherita Nosadini +11 more
TL;DR: Observational data support the use of corticosteroids, antibiotics, and sodium valproate for treatment of Sydenham chorea.
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A Refractory Case of Sydenham Chorea Managed With Intravenous Pulse‐Dose Methylprednisolone
Andrea Weitz,Inna Kaminecki,Clark Azubuike,Sai Pranathi Bingi,Jennifer E. Wilson,Michael Mitchell,Mary Baiyeri,María Gasque,Andrea Weitz,Inna Kaminecki,Clark Azubuike,Sai Pranathi Bingi,Jennifer E. Wilson,Michael Mitchell,Mary Baiyeri,María Gasque +15 more
Abstract: We describe the case of an eight‐year‐old female presenting with abrupt‐onset involuntary movements, emotional lability, and gait disturbances, consistent with Sydenham’s chorea (SC). Her condition deteriorated despite initial antibiotic treatment and symptomatic management. Notable findings included elevated antistreptolysin O titers and antideoxyribonuclease B antibodies, suggestive of recent Group A Streptococcus infection. Brain magnetic resonance imaging revealed punctate gliosis in the supratentorial white matter, and extensive workup excluded alternative diagnoses. Despite escalating therapy with valproic acid, clonidine, and haloperidol, the patient exhibited persistent choreiform movements and emotional dysregulation. High‐dose corticosteroids (methylprednisolone) were initiated, resulting in significant symptomatic improvement and restoration of ambulatory function. Long‐term prophylaxis with benzathine penicillin G was implemented to prevent recurrence. SC remains an under‐researched complication of acute rheumatic fever, with treatment often extrapolated from limited case reports and expert consensus. This case underscores the potential role of corticosteroids in refractory SC. This case also highlights the complexity of managing prolonged SC and the importance of individualized, multifaceted treatment strategies.
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SciPy 1.0--Fundamental Algorithms for Scientific Computing in Python
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TL;DR: SciPy as discussed by the authors is an open source scientific computing library for the Python programming language, which includes functionality spanning clustering, Fourier transforms, integration, interpolation, file I/O, linear algebra, image processing, orthogonal distance regression, minimization algorithms, signal processing, sparse matrix handling, computational geometry, and statistics.
Treatment of Sydenham's chorea with intravenous immunoglobulin, plasma exchange, or prednisone.
TL;DR: Clinical improvements appeared to be more rapid and robust in the intravenous immunoglobulin and plasma exchange groups than in the prednisone group, and larger studies are required to confirm these clinical observations and to determine if these treatments are cost-effective for this disorder.
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Randomized double-blind study with prednisone in Sydenham's chorea.
TL;DR: Although initial chorea intensity was similar in both groups, a significant difference was observed after 1 week of medication, with a larger reduction in the prednisone group, that continued until the end of the study.
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An update on the treatment of Sydenham's chorea: the evidence for established and evolving interventions.
Kathleen Walker,Jo M. Wilmshurst +1 more
TL;DR: Small studies have demonstrated trends to support the use of immunoglobulins and steroids as therapeutic interventions for children affected by Sydenham’s chorea.
Recurrence of Sydenham Chorea: Implications for Pathogenesis
TL;DR: In a significant subgroup of patients, SC recurrence might not be a true relapse of rheumatic fever and might represent either a primary underlying abnormality that renders patients susceptible to developing such a movement disorder or the outcome of permanent subclinical damage to the basal ganglia following the initial SC episode.
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