耐心是关键：一名唐氏综合征女孩的避孕药诱发的舞蹈病。
Patience is the key: Contraceptive induced chorea in a girl with Down Syndrome.
作者信息
Eggink Hendriekje, Kuiper Anouk, Delnooz Cathérine C S, Sival Deborah A, de Koning Tom J, Tijssen Marina A J
机构信息
University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
University of Groningen, University Medical Center Groningen, Department of Neurology, Hanzeplein 1, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Pediatrics, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
出版信息
Eur J Paediatr Neurol. 2016 Jul;20(4):671-3. doi: 10.1016/j.ejpn.2016.03.004. Epub 2016 Mar 25.
BACKGROUND
Isolated (sub)acute chorea in young patients is a relatively rare movement disorder with a broad differential diagnosis, including drug-induced, post-infectious, auto-immunological and vascular aetiologies.
CASE PRESENTATION
We describe an adolescent girl with Down's syndrome presenting with chorea due to oral contraceptive usage. After discontinuation of the oral contraceptive it took several months before the symptoms disappeared. Although generally well recognised, it is important to realise this delayed effect. Rejecting the diagnosis too soon may lead to unnecessary treatment for other possible underlying aetiologies, especially in patients with Down Syndrome, known to be vulnerable for autoimmune disorders.
CONCLUSION
We plead for discontinuation for at least three months before exclusion of oral contraceptives as cause of chorea.
背景
年轻患者中孤立性（亚）急性舞蹈症是一种相对罕见的运动障碍，鉴别诊断范围广泛，包括药物性、感染后、自身免疫性和血管性病因。
病例报告
我们描述了一名患有唐氏综合征的青春期女孩，因使用口服避孕药出现舞蹈症。停用口服避孕药后，症状持续数月才消失。尽管这一情况通常广为人知，但认识到这种延迟效应很重要。过早排除诊断可能导致针对其他可能潜在病因进行不必要的治疗，尤其是对于已知易患自身免疫性疾病的唐氏综合征患者。
结论
我们主张在排除口服避孕药作为舞蹈症病因之前，至少停药三个月。
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