Hemichorea with antiphospholipid antibodies in a patient with lupus nephritis.
Although central nervous system involvement is an important manifestation of systemic lupus erythematosus (SLE), chorea is a relatively uncommon complication. A strong association between chorea and the presence of antiphospholipid antibodies (aPLs) has been reported in patients with SLE, lupus-like disease, or primary antiphospholipid syndrome. We describe a patient with lupus nephritis and cerebral infarction, who subsequently developed recurrent hemichorea associated with increased aPLs levels. A 7-year-old boy suffered from lupus nephritis and a left middle cerebral artery infarction associated with aPLs. He subsequently experienced two episodes of right hemichorea associated with increased aPLs levels without any evidence of further neurological lesions by brain computed tomography or magnetic resonance imaging. The previous left cerebral artery infarction might have increased the susceptibility of the left basal ganglia to the effects of aPLs that contributed to the development of the right hemichorea in this patient.
Watanabe
Toru
T
Department of Pediatrics, Niigata City General Hospital, 2-6-1 Shichikuyama, Niigata 950-8739, Japan. twata@hosp.niigata.niigata.jp
Onda
Hiroo
H
D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000150:complications; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002819:Chorea / Q000188:drug therapy / Q000209:etiology*; D007839:Functional Laterality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008181:Lupus Nephritis / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D012263:Ribonucleosides / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D017152:Antibodies, Antiphospholipid; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine