de Carvalho Jozélio Freire, Churilov Leonid P
Institute for Health Sciences from Federal University of Bahia, Salvador, Bahia, Brazil.
Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Russia.
Mediterr J Rheumatol. 2021 Dec 27;32(4):369-372. doi: 10.31138/mjr.32.4.369. eCollection 2021 Dec.
Sydenham's chorea is a cardinal manifestation of rheumatic fever, but it is more common in girls. We describe two boys who developed Sydenham's chorea and were successfully treated.
CASE 1: A 5-year-old boy started an involuntary movement of his hand, progressing to all the upper limbs, bilaterally. The family observed a deterioration in his handwriting skills. Heart auscultation did not reveal any murmur, and the oropharynx examination was normal. A brain magnetic resonance imaging, cerebrospinal fluid, and echocardiography were interpreted as normal. He was treated with valproate 2.5mL twice a day. Prophylaxis with benzathine penicillin was started using 600,000IU every 21 days. After four months, the patient was asymptomatic, and valproate was tapered off.
CASE 2: A 7-year-old boy with a long history of frequent otitis and pharyngitis started involuntary movements of his face and on his upper limbs, and also, his mother noted tics on his face. A brain magnetic resonance imaging and transthoracic echocardiography were normal. He was treated with haloperidol 10 drops (1mg) twice a day, and prophylaxis with benzathine penicillin was started using 600,000IU every 21 days. After three months, the patient was asymptomatic, all chorea manifestations resolved, haloperidol was then tapered off. In conclusion, this study illustrates two uncommon cases of boys who developed Sydenham's chorea and had a good outcome.
Sydenham舞蹈病是风湿热的主要表现，但在女孩中更为常见。我们描述了两名患Sydenham舞蹈病并成功治愈的男孩。
病例1：一名5岁男孩开始出现手部不自主运动，逐渐发展至双侧上肢。家人发现他的书写技能有所下降。心脏听诊未发现杂音，口咽部检查正常。脑部磁共振成像、脑脊液检查和超声心动图检查结果均正常。他接受了丙戊酸盐治疗，每天两次，每次2.5毫升。开始每21天使用60万国际单位苄星青霉素进行预防治疗。四个月后，患者无症状，丙戊酸盐逐渐减量。
病例2：一名7岁男孩有频繁中耳炎和咽炎病史，开始出现面部和上肢不自主运动，其母亲还注意到他面部有抽搐。脑部磁共振成像和经胸超声心动图检查正常。他接受了氟哌啶醇治疗，每天两次，每次10滴（1毫克），并开始每21天使用60万国际单位苄星青霉素进行预防治疗。三个月后，患者无症状，所有舞蹈病表现均消失，随后氟哌啶醇逐渐减量。总之，本研究说明了两名患Sydenham舞蹈病的男孩的罕见病例，且预后良好。
