[Involuntary movement disorders as first manifestation of systemic lupus erythematosus: case report].
We describe a 36 year-old woman who developed chorea two months after starting the use of oral contraceptives. She also developed thrombocytopenia, oral ulcers, arthritis, positive antinuclear antibodies (ANA), anti-Sm and anti-DNA, filling criteria for systemic lupus erythematosus, as defined by the American College of Rheumatology. The tests for lupus anticoagulant and anticardiolipin (IgG and IgM) were negative. The patient was treated with prednisone, phenitoin, phenobarbital and clonazepam, obtaining clinical and labatorial improvement. We discuss the ocurrence of chorea and other movement disorders as first manifestation of systemic lupus erythematosus, its relationship with oral contraceptives and antiphospholipid antibodies.
Kakehasi
A M
AM
Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal da Minas Gerais, Belo Horizonte, MG, Brasil. amkake@hotmail.com
Bomtempo
C A
CA
Vassalo
S
S
Pimenta
R C
RC
Carvalho
M A
MA
Cardoso
F
F
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000032:analysis; D000927:Anticonvulsants / Q000627:therapeutic use; D002819:Chorea / Q000188:drug therapy / Q000209:etiology*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D017152:Antibodies, Antiphospholipid; D000927:Anticonvulsants; D003278:Contraceptives, Oral, Hormonal