TY - JOUR
T1 - Sydenham’s chorea
T2 - from pathophysiology to therapeutics
AU - Teixeira, Antonio L.
AU - Vasconcelos, Luiz P.
AU - Nunes, Maria do Carmo Pereira
AU - Singer, Harvey
N1 - Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Sydenham’s chorea is an autoimmune chorea emerging after a group A beta-hemolytic streptococcal (GABHS) infection, i.e. a rheumatic chorea with or without the presence of carditis or arthritis. The disorder, defined by the presence of chorea, is also associated with cognitive and behavioral symptoms, including emotional lability, anxiety, depressive and obsessive-compulsive symptoms. The authors review the pathophysiology, clinical characteristics, and available evidence on therapeutic strategies, the latter including the secondary prevention of GABHS infections, reduction of chorea, and immune modulation. Sydenham’s chorea has been regarded as a model for pediatric autoimmune neuropsychiatric disorders, however, the field is marked by conflicting results and controversies. Regarding therapeutics, there are limited high-quality interventional studies and the selection of treatment strategy often relies on the clinician’s experience. A serial treatment algorithm is presented based upon the severity of clinical presentation and response to symptomatic pharmacotherapy.
AB - Sydenham’s chorea is an autoimmune chorea emerging after a group A beta-hemolytic streptococcal (GABHS) infection, i.e. a rheumatic chorea with or without the presence of carditis or arthritis. The disorder, defined by the presence of chorea, is also associated with cognitive and behavioral symptoms, including emotional lability, anxiety, depressive and obsessive-compulsive symptoms. The authors review the pathophysiology, clinical characteristics, and available evidence on therapeutic strategies, the latter including the secondary prevention of GABHS infections, reduction of chorea, and immune modulation. Sydenham’s chorea has been regarded as a model for pediatric autoimmune neuropsychiatric disorders, however, the field is marked by conflicting results and controversies. Regarding therapeutics, there are limited high-quality interventional studies and the selection of treatment strategy often relies on the clinician’s experience. A serial treatment algorithm is presented based upon the severity of clinical presentation and response to symptomatic pharmacotherapy.
KW - Sydenham’s chorea
KW - anti-basal ganglia antibodies
KW - corticosteroids
KW - dopamine antagonists
KW - pandas
KW - penicillin
KW - rheumatic chorea
KW - rheumatic fever
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85113213270&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85113213270&partnerID=8YFLogxK
U2 - 10.1080/14737175.2021.1965883
DO - 10.1080/14737175.2021.1965883
M3 - Review article
C2 - 34353207
AN - SCOPUS:85113213270
SN - 1473-7175
VL - 21
SP - 913
EP - 922
JO - Expert review of neurotherapeutics
JF - Expert review of neurotherapeutics
IS - 8
ER -