Top

Published in:

01-06-2020 | Rheumatic Fever | Short Communication

Preliminary data on prednisone effectiveness in children with Sydenham chorea

Authors: Elena Favaretto, Giulia Gortani, Gabriele Simonini, Serena Pastore, Alberto Di Mascio, Rolando Cimaz, Andrea Taddio

Published in: European Journal of Pediatrics | Issue 6/2020

Abstract

The objective of the study is to evaluate the efficacy of corticosteroids in Sydenham chorea. This is a retrospective observational study. Clinical information of children with Sydenham chorea were collected. Outcome of Sydenham chorea was evaluated in consideration of presence or absence of corticosteroid therapy. Thirty patients were enrolled. A total of 15 were treated with prednisone, 15 received symptomatic drugs or no treatment. Patients who were treated with prednisone showed faster improvement (4 vs 16 days; p = 0.002) and shorter median time of remission (30 vs 135 days; p < 0.001).

Conclusion: Our study showed that corticosteroid therapy is an effective treatment of Sydenham chorea.

What is Known: • Steroid treatment in Sydenham chorea is widely used but it is not standardized. • Few manuscript report a beneficial use of steroids in Sydenham chorea if compared with no treatment.
What is New: • Steroid treatment seems to be effective in both clinical remission and clinical improvement of symptoms among patients with Sydenham chorea. • Steroid treatment seems to be superior to conventional treatment.

Available only for authorised users

Gewitz MH, Baltimore RS, Tani LY, Sable CA, Shulman ST, Carapetis J, Remenyi B, Taubert KA, Bolger AF, Beerman L, Mayosi BM, Beaton A, Pandian NG, Kaplan EL (2015) Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 131:1806–1818. https://doi.org/10.1161/CIR.0000000000000205 CrossRefPubMed

Carapetis J, Beaton CMW, Guilherme L, Karthikeyan G, Mayosi BM, Sable C, Steer A, Wilson N, Wyber R, Zühlke L (2016) Acute rheumatic fever and heart rheumatic disease. Nat Rev Dis Primers 2:15084. https://doi.org/10.1038/nrdp.2015.84 CrossRefPubMedPubMedCentral

Kirvan CA, Cox CJ, Swedo SE, Cunningham MW (2007) Tubulin is a neuronal target of autoantibodies in Sydenham’s chorea. J Immunol 178:7412–7421. https://doi.org/10.4049/jimmunol.178.11.7412 CrossRefPubMed

Cox CJ, Sharma M, Leckman JF, Zuccolo J, Zuccolo A, Kovoor A, Swedo SE, Cunningham MW (2013) Brain human monoclonal autoantibody from Sydenham chorea targets dopaminergic neurons in transgenic mice and signals dopamine D2 receptor: implications in human disease. J Immunol 191:5524–5541. https://doi.org/10.4049/jimmunol.1102592 CrossRefPubMed

Dean SL, Singer HS (2017) Treatment of Sydenham’s chorea: a review of the current evidence. Tremor Other Hyperkinet Mov (N Y) 7:456. https://doi.org/10.7916/D8W95GJ2 CrossRef

Paz JA, Silva CA, Marques-Dias MJ (2006) Randomized double-blind study with prednisone in Sydenham’s chorea. Pediatr Neurol 34:264–269. https://doi.org/10.1016/j.pediatrneurol.2005.08.028 CrossRefPubMed

Garvey MA, Snider SF, Leitman SF, Werden R, Swedo SE (2005) Treatment of Sydenham’s chorea with intravenous immunoglobulin, plasma exchange, or prednisone. J Child Neurol 20:424–429. https://doi.org/10.1177/08830738050200050601 CrossRefPubMed

Dajani AS, Ayoub E, Bierman FZ, Bisno AL, Denny FW, Durack DT, Ferrieri P, Freed M, Gerber M, Kaplan E, Karchmer AM, Markowitz M, Shahbudin R, Shulman ST, Stollerman G, Takahashi M, Taranta A, Taubert K, Wilson W (1992) Guidelines for the diagnosis of rheumatic fever: Jones criteria, 1992 update. JAMA 268:2069–2073. https://doi.org/10.1001/jama.1992.03490150121036 CrossRef

Church AJ, Cardoso F, Dale RC, Lees AJ, Thompson EJ, Giovannoni G (2002) Anti-basal ganglia antibodies in acute and persistent Sydenham’s chorea. Neurology 59:227–231. https://doi.org/10.1212/wnl.59.2.227 CrossRefPubMed

10.

Green LN (1978) Corticosteroids in the treatment of Sydenham’s chorea. Arch Neurol 35:53–54CrossRef

11.

Walker AR, Tani LY, Thompson JA, Firth SD, Veasy LG, Bale JF (2007) Rheumatic chorea: relationship to systemic manifestations and response to corticosteroids. J Pediatr 6:679–683. https://doi.org/10.1016/j.jpeds.2007.04.059 CrossRef

12.

Barash J, Margalith D, Matitiau A (2005) Corticosteroid treatment in patients with Sydenham’s chorea. Pediatr Neurol 3:205–207CrossRef

Title: Preliminary data on prednisone effectiveness in children with Sydenham chorea
Authors: Elena Favaretto
Giulia Gortani
Gabriele Simonini
Serena Pastore
Alberto Di Mascio
Rolando Cimaz
Andrea Taddio
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Rheumatic Fever
Post-Infection Chorea and Chorea Gravidarum
Published in: European Journal of Pediatrics / Issue 6/2020
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-020-03574-y

2024 ASCO Annual Meeting

Springer Medicine

Preliminary data on prednisone effectiveness in children with Sydenham chorea

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2020

Assessing key clinical parameters before and after intraventricular hemorrhage in very preterm infants

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial

Clinico-laboratory profile of Kawasaki disease with arthritis in children

Efficacy of double versus single phototherapy in treatment of neonatal jaundice: a meta-analysis

Proportional assist ventilation (PAV) versus neurally adjusted ventilator assist (NAVA): effect on oxygenation in infants with evolving or established bronchopulmonary dysplasia

Blastocystis in Swiss children: a practical approach