title: Sydenham's chorea--clinical and evolutive characteristics.
abstract: BACKGROUND
  During the last 12 years we have observed an increase in the frequency of Sydenham's chorea in our country. We have observed that some of our patients have presented recurrence of the chorea despite regular treatment with benzathine penicillin.
  
  
  OBJECTIVE
  The aim of our study was to evaluate clinical and evolutive characteristics of Sydenham's chorea in a group of patients followed in our Pediatric Rheumatology Unit.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Section of Pediatric Rheumatology - Discipline of Allergy, Clinical Immunology and Rheumatology - Department of Pediatrics - UNIFESP - EPM.
  
  
  METHODS
  Two hundred and ninety patients with rheumatic fever followed between 1986 and 1999.
  
  
  METHODS
  We reviewed the records of 290 patients with rheumatic fever followed between 1986 and 1999. All patients were diagnosed according to the revised Jones criteria (1992). We included 86 patients that presented Sydenham's chorea as one of the major criteria (one or more attacks) and evaluated their clinical and evolutive characteristics as well the treatment.
  
  
  RESULTS
  Fifty-five patients were girls and 31 were boys. The mean age at onset was 9.7 years and mean follow-up period was 3.6 years. The 86 Sydenham's chorea patients presented 110 attacks of chorea. We observed isolated chorea in 35% of the patients, and 25 (29%) presented one or more recurrences. We included only 17 of the 25 patients for further analysis, with a total of 22 recurrences of which 14 were attacks of chorea, because it was not possible to precisely detect the interval between attacks in the other patients. The approximate interval between the attacks ranged from 4 to 96 months. In 71% of the patients there was no failure in the secondary prophylaxis with benzathine penicillin, which was performed every 3 weeks.
  
  
  CONCLUSIONS
  Despite the regular use of secondary benzathine penicillin prophylaxis, children with rheumatic fever have a high risk of Sydenham's chorea recurrence.
authors.affiliation: Section of Pediatric Rheumatology, Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil. terreri@uninet.com.br
authors.forename: Maria Teresa Ramos Ascensão
authors.initials: MT
authors.lastname: Terreri
authors.forename: Suzana Campos
authors.initials: SC
authors.lastname: Roja
authors.forename: Claudio Arnaldo
authors.initials: CA
authors.lastname: Len
authors.forename: Patricia Corte
authors.initials: PC
authors.lastname: Faustino
authors.forename: Adriana Madureira
authors.initials: AM
authors.lastname: Roberto
authors.forename: Maria Odete Esteves
authors.initials: MO
authors.lastname: Hilário
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002819:Chorea / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D010401:Penicillin G Benzathine / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D010406:Penicillins; D010401:Penicillin G Benzathine