title: Long-term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies.
abstract: OBJECTIVE
  The aim of this work was to describe chorea during systemic lupus erythematosus or antiphospholipid antibodies and its long-term outcome.
  
  
  METHODS
  We retrospectively analyzed clinical features, laboratory findings, imaging characteristics, and outcome in a series of 32 patients.
  
  
  RESULTS
  Most patients were women (28 of 32), and mean age at onset of chorea was 20.6 (9-62) years. Chorea was inaugural for 28 patients. Improvement was observed with various treatments. During follow-up (12.2 ± 11.3 years), severe manifestations of systemic lupus erythematosus were rare. Antiphospholipid antibodies were repeatedly positive for 90% of the patients. Twelve patients developed arterial thrombosis. Prophylactic treatment with antithrombotic therapy might reduce the risk of further thrombosis (8% versus 57%; P = 0.01). Cardiac valvulopathy occurred in 22 patients during follow-up. Chorea relapsed in 8 cases.
  
  
  CONCLUSIONS
  Chorea had a good outcome in itself. This long-term follow-up shows, for the first time, that these patients have substantial risk for further arterial thrombosis.
authors.affiliation: Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France. peggyreiner@yahoo.fr
authors.forename: Peggy
authors.initials: P
authors.lastname: Reiner
authors.forename: Damien
authors.initials: D
authors.lastname: Galanaud
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Leroux
authors.forename: Marie
authors.initials: M
authors.lastname: Vidailhet
authors.forename: Julien
authors.initials: J
authors.lastname: Haroche
authors.forename: Du Le Thi
authors.initials: du LT
authors.lastname: Huong
authors.forename: Camille
authors.initials: C
authors.lastname: Francès
authors.forename: Thomas
authors.initials: T
authors.lastname: Papo
authors.forename: Christian
authors.initials: C
authors.lastname: de Gennes
authors.forename: Lucile
authors.initials: L
authors.lastname: Musset
authors.forename: Bertrand
authors.initials: B
authors.lastname: Wechsler
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
mesh_terms: D000293:Adolescent; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000096:biosynthesis*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001158:Arteries / Q000503:physiopathology; D002648:Child; D002819:Chorea / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D013256:Steroids / Q000627:therapeutic use; D013927:Thrombosis / Q000276:immunology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D014150:Antipsychotic Agents; D013256:Steroids