[Acute poststreptoccocal chorea: an atypical postoperative reaction following cardiac surgery for mitral valvulopathy].
We report on a 12-year-old patient from Congo who presented acute chorea following cardiac surgery for poststreptococcal mitral valvulopathy. She showed severe and asymmetrical chorea, associated with motor impersistence and agitation. Biological investigations disclosed inflammatory signs and brain MRI was normal. Due to the negative results of the biological and morphological investigations, the diagnosis of Sydenham chorea was suspected. High doses of oral steroids resulted in a dramatic improvement of the chorea as well as the behavior disturbance within 1 month. Sydenham chorea is not an unusual complication of rheumatic fever. Usually, patients develop chorea a few weeks after beta-hemolytic streptococcal pharyngitis. Details on its pathophysiology remain to be determined. Our case highlights its possible onset in the postoperative period if alternative etiologies of infantile chorea have been excluded.
Brousse
V
V
Service de pédiatrie générale, hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015 Paris, France. valentine.brousse@nck.aphp.fr
Bahi-Buisson
N
N
Lucet
V
V
Deloche
A
A
Abadie
V
V
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001921:Brain / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002819:Chorea / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003223:Congo / Q000208:ethnology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009460:Neurologic Examination / Q000187:drug effects; D010406:Penicillins / Q000008:administration & dosage; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage; D012214:Rheumatic Heart Disease / Q000601:surgery*; D013290:Streptococcal Infections / Q000601:surgery*; D013297:Streptococcus pyogenes; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
D000893:Anti-Inflammatory Agents; D010406:Penicillins; D002097:C-Reactive Protein; D011241:Prednisone