Carapetis J R, Currie B J
Division of Infectious Diseases, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
Arch Dis Child. 1999 Apr;80(4):353-8. doi: 10.1136/adc.80.4.353.
To describe the epidemiology and clinical features of Sydenham's chorea in the Aboriginal population of northern Australia a review was conducted of 158 episodes in 108 people: 106 were Aborigines, 79 were female, and the mean age was 10.9 years at first episode. Chorea occurred in 28% of cases of acute rheumatic fever, carditis occurred in 25% of episodes of chorea, and arthritis in 8%. Patients with carditis or arthritis tended to have raised acute phase reactants and streptococcal serology. Two episodes lasted at least 30 months. Mean time to first recurrence of chorea was 2.1 years compared with 1.2 years to second recurrence. Established rheumatic heart disease developed in 58% of cases and was more likely in those presenting with acute carditis, although most people who developed rheumatic heart disease did not have evidence of acute carditis with chorea. Differences in the patterns of chorea and other manifestations of acute rheumatic fever in different populations may hold clues to its pathogenesis. Long term adherence to secondary prophylaxis is crucial following all episodes of acute rheumatic fever, including chorea, to prevent recurrence.
为描述澳大利亚北部原住民人群中 Sydenham 舞蹈病的流行病学特征和临床特点，对 108 人发生的 158 次发病情况进行了回顾性研究：其中 106 人为原住民，79 人为女性，首次发病的平均年龄为 10.9 岁。舞蹈病发生于 28%的急性风湿热病例中，心脏炎发生于 25%的舞蹈病发作中，关节炎发生于 8%的病例中。患有心脏炎或关节炎的患者往往急性期反应物和链球菌血清学指标升高。有两次发作持续至少 30 个月。舞蹈病首次复发的平均时间为 2.1 年，第二次复发的平均时间为 1.2 年。58%的病例发展为慢性风湿性心脏病，急性心脏炎患者更易发生，不过大多数发生慢性风湿性心脏病的人并无舞蹈病伴急性心脏炎的证据。不同人群中舞蹈病及急性风湿热其他表现形式的差异可能为其发病机制提供线索。在包括舞蹈病在内的所有急性风湿热发作后，长期坚持二级预防对于预防复发至关重要。
