Van der Merwe P L, Kalis N N
Department of Paediatrics and Child Health, University of Stellenbosch.
S Afr Med J. 1997 Jun;87 Suppl 3:C157-60.
The first documented epidemic of Sydenham's chorea was in 1418. In 1686 Thomas Sydenham was the first to describe the condition, but it was Richard Bright who in 1831 first made the association between chorea and rheumatic fever. Chorea is one of the major diagnostic criteria for rheumatic fever. Chorea is often considered a benign self-limiting condition. Little is known about the pathophysiological process. A link between the group A beta-haemolytic streptococcus through an antibody-mediated immune response targeting the basal ganglia has been described. Special investigations have been done to ascertain the pathophysiology, but none is of diagnostic value. The aims of this study were to analyse the clinical findings, the role of special investigations in the management and course of Sydenham's chorea and to review the literature. Data on 27 patients were analysed. Special investigations in these patients can be divided into those necessary to assist in diagnosing acute rheumatic fever and those to exclude other causes that mimic chorea. None of these tests was helpful in diagnosing chorea due to other causes; neither did they influence the management of these patients. In conclusion, Sydenham's chorea remains a clinical diagnosis and extensive and expensive special investigations are seldom warranted.
有记录的首例西德纳姆舞蹈病流行发生在1418年。1686年，托马斯·西德纳姆首次描述了这种病症，但直到1831年，理查德·布莱特才首次提出舞蹈病与风湿热之间存在关联。舞蹈病是风湿热的主要诊断标准之一。舞蹈病通常被认为是一种良性自限性病症。人们对其病理生理过程知之甚少。已经描述了A组β溶血性链球菌通过针对基底神经节的抗体介导免疫反应建立的一种联系。为确定病理生理学进行了专项研究，但均无诊断价值。本研究的目的是分析临床发现、专项检查在西德纳姆舞蹈病的管理及病程中的作用，并对相关文献进行综述。分析了27例患者的数据。这些患者的专项检查可分为有助于诊断急性风湿热的检查和用于排除其他类似舞蹈病病因的检查。这些检查均无助于诊断由其他病因引起的舞蹈病，也未对这些患者的治疗产生影响。总之，西德纳姆舞蹈病仍然是一种临床诊断，很少需要进行广泛且昂贵的专项检查。
