Sydenham's chorea--clinical and evolutive characteristics.
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.
Terreri
Maria Teresa Ramos Ascensão
MT
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
Roja
Suzana Campos
SC
Len
Claudio Arnaldo
CA
Faustino
Patricia Corte
PC
Roberto
Adriana Madureira
AM
Hilário
Maria Odete Esteves
MO
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
D010406:Penicillins; D010401:Penicillin G Benzathine