Teixeira Antonio L, Vasconcelos Luiz P, Nunes Maria do Carmo Pereira, Singer Harvey
Infectious Diseases and Tropical Medicine Graduation Program, School of Medicine, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil.
Institute of Education and Research, Santa Casa Bh, Belo Horizonte, Brazil.
Expert Rev Neurother. 2021 Aug;21(8):913-922. doi: 10.1080/14737175.2021.1965883. Epub 2021 Aug 18.
Sydenham's chorea is an autoimmune chorea emerging after a group A beta-hemolytic streptococcal (GABHS) infection, i.e. a rheumatic chorea with or without the presence of carditis or arthritis. The disorder, defined by the presence of chorea, is also associated with cognitive and behavioral symptoms, including emotional lability, anxiety, depressive and obsessive-compulsive symptoms. The authors review the pathophysiology, clinical characteristics, and available evidence on therapeutic strategies, the latter including the secondary prevention of GABHS infections, reduction of chorea, and immune modulation. Sydenham's chorea has been regarded as a model for pediatric autoimmune neuropsychiatric disorders, however, the field is marked by conflicting results and controversies. Regarding therapeutics, there are limited high-quality interventional studies and the selection of treatment strategy often relies on the clinician's experience. A serial treatment algorithm is presented based upon the severity of clinical presentation and response to symptomatic pharmacotherapy.
西德纳姆舞蹈病是一种在A组β溶血性链球菌（GABHS）感染后出现的自身免疫性舞蹈病，即伴有或不伴有心脏炎或关节炎的风湿性舞蹈病。该疾病由舞蹈病的存在所定义，还与认知和行为症状相关，包括情绪不稳定、焦虑、抑郁和强迫症状。作者回顾了其病理生理学、临床特征以及治疗策略的现有证据，后者包括GABHS感染的二级预防、舞蹈病的减轻和免疫调节。西德纳姆舞蹈病一直被视为儿童自身免疫性神经精神疾病的一个模型，然而，该领域存在相互矛盾的结果和争议。在治疗方面，高质量的干预性研究有限，治疗策略的选择往往依赖于临床医生的经验。根据临床表现的严重程度和对症药物治疗的反应，提出了一种系列治疗算法。
