title: Chorea in systemic lupus erythematosus.
abstract: BACKGROUND
  Chorea is recognized as one of the neurologic manifestations of systemic lupus erythematosus (SLE). Most reports show an association between chorea and antiphospholipid (aPL) antibodies in SLE patients.
  
  
  OBJECTIVE
  The objective of this study was to describe the association of aPL antibodies with lupus chorea and its possible role in the pathogenesis of chorea.
  
  
  METHODS
  We made a retrospective review of all cases of lupus chorea between 1989 and 2007 in a tertiary care center in Mexico City.
  
  
  RESULTS
  We found 7 episodes of chorea in 5 patients with SLE. In 2 patients (3 episodes), chorea was associated with cerebral ischemia; one of these cases had positive anticardiolipin (aCL) immunoglobulin G (IgG) antibodies, whereas the other was diagnosed as having vascular lipohyalinosis as the probable cause of cerebral ischemia. In 3 patients (4 episodes), an immune-mediated mechanism was suspected; these cases had negative aPL at the onset of chorea, but IgM aCL antibodies became positive later.
  
  
  CONCLUSIONS
  In most episodes, chorea seems to be immunologically mediated and was associated with a later appearance of IgM aCL antibodies. Chorea in patients with lupus may also be caused by cerebral ischemia, and in some cases, it may be associated with IgG aCL antibodies.
authors.affiliation: Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. baicarjf@gmail.com
authors.forename: José Fidel
authors.initials: JF
authors.lastname: Baizabal-Carvallo
authors.forename: Marlene
authors.initials: M
authors.lastname: Alonso-Juarez
authors.forename: Michael
authors.initials: M
authors.lastname: Koslowski
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000502:physiology; D017152:Antibodies, Antiphospholipid / Q000502:physiology; D001812:Blood-Brain Barrier / Q000503:physiopathology; D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology; D002819:Chorea / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000502:physiology; D007075:Immunoglobulin M / Q000502:physiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000503:physiopathology*; D012189:Retrospective Studies
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G; D007075:Immunoglobulin M