title: Antiphospholipid-related chorea.
abstract: Chorea is a movement disorder which may be associated with immunologic diseases, in particular in the presence of antiphospholipid antibodies (aPL). Choreic movements have been linked to the isolated presence of plasmatic aPL, or to primary, or secondary antiphospholipid syndrome. The highest incidence of aPL-related chorea is detected in children and females. The presentation of chorea is usually subacute and the course monophasic. Choreic movements can be focal, unilateral, or generalized. High plasmatic titers of aPL in a choreic patient can suggest the diagnosis of aPL-related chorea; neuroimaging investigation does not provide much additional diagnostic information. The most relevant target of aPL is β2-glycoprotein I, probably responsible for the thrombotic manifestations of antiphospholipid syndrome. Etiology of the movement disorder is not well understood but a neurotoxic effect of aPL has been hypothesized, leading to impaired basal ganglia cell function and development of neuroinflammation. Patients affected by aPL-related chorea have an increased risk of thrombosis and should receive antiplatelet or anticoagulant treatment.
authors.affiliation: Department of Neurological Sciences, Federico II University Naples, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Peluso
authors.forename: Antonella
authors.initials: A
authors.lastname: Antenora
authors.forename: Anna
authors.initials: A
authors.lastname: De Rosa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Roca
authors.forename: Gennaro
authors.initials: G
authors.lastname: Maddaluno
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Brescia Morra
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Michele
keywords: APS; Hughes’ syndrome; anti-β2-glycoprotein I antibodies; anticardiolipin antibodies; antiphospholipid antibody syndrome; antiphospholipid syndrome; chorea; lupus anticoagulant