Rheumatic Chorea: Relationship to Systemic Manifestations and Response to Corticosteroids
Objective To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF). Study design An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through Ja...
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Veröffentlicht in: | The Journal of pediatrics 2007-12, Vol.151 (6), p.679-683 |
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creator | Walker, Adrianne R., MD Tani, Lloyd Y., MD Thompson, Joel A., MD Firth, Sean D., PhD, MPH Veasy, L. George, MD Bale, James F., MD |
description | Objective To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF). Study design An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through January 2002. Results Of 584 cases in the database, 537 (91%) were new-onset RF (median age of 10 years) and 177 (33%) had chorea. Patients with chorea were more often female (OR = 0.37, 95% CI = 0.25-0.55, P < .0001) and were less likely to have carditis or arthritis. Prednisone treatment may lead to a shortened course of chorea (4.0 weeks in prednisone-treated [n = 32] vs 9.0 weeks in untreated [n = 14]; P < .0001). Among 33 patients seen at a median of 10.3 years (range 6.3-14.9 years) after their initial bout of chorea, 20% reported residual tremor or mood swings. Ten of the 33 (30%) had one or more recurrences of chorea. Conclusions Chorea affected one-third of the children with RF. Patients with chorea were less likely to have severe cardiac or rheumatologic complications of RF. Therapy with prednisone shortened the duration of rheumatic chorea; some reported recurrences of chorea and had minor neurologic sequelae. |
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George, MD ; Bale, James F., MD</creator><creatorcontrib>Walker, Adrianne R., MD ; Tani, Lloyd Y., MD ; Thompson, Joel A., MD ; Firth, Sean D., PhD, MPH ; Veasy, L. George, MD ; Bale, James F., MD</creatorcontrib><description>Objective To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF). Study design An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through January 2002. Results Of 584 cases in the database, 537 (91%) were new-onset RF (median age of 10 years) and 177 (33%) had chorea. Patients with chorea were more often female (OR = 0.37, 95% CI = 0.25-0.55, P < .0001) and were less likely to have carditis or arthritis. Prednisone treatment may lead to a shortened course of chorea (4.0 weeks in prednisone-treated [n = 32] vs 9.0 weeks in untreated [n = 14]; P < .0001). Among 33 patients seen at a median of 10.3 years (range 6.3-14.9 years) after their initial bout of chorea, 20% reported residual tremor or mood swings. Ten of the 33 (30%) had one or more recurrences of chorea. Conclusions Chorea affected one-third of the children with RF. Patients with chorea were less likely to have severe cardiac or rheumatologic complications of RF. Therapy with prednisone shortened the duration of rheumatic chorea; some reported recurrences of chorea and had minor neurologic sequelae.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2007.04.059</identifier><identifier>PMID: 18035153</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Child ; Child, Preschool ; Chorea - drug therapy ; Chorea - etiology ; Female ; General aspects ; Glucocorticoids - therapeutic use ; Humans ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Pediatrics ; Prednisone - therapeutic use ; Rheumatic Fever - complications ; Risk Factors</subject><ispartof>The Journal of pediatrics, 2007-12, Vol.151 (6), p.679-683</ispartof><rights>Mosby, Inc.</rights><rights>2007 Mosby, Inc.</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-5e4df27beef4280be8e29b608ea0b2756c1ff7564ecd771df87f7dfb1f63bc473</citedby><cites>FETCH-LOGICAL-c442t-5e4df27beef4280be8e29b608ea0b2756c1ff7564ecd771df87f7dfb1f63bc473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2007.04.059$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19907667$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18035153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walker, Adrianne R., MD</creatorcontrib><creatorcontrib>Tani, Lloyd Y., MD</creatorcontrib><creatorcontrib>Thompson, Joel A., MD</creatorcontrib><creatorcontrib>Firth, Sean D., PhD, MPH</creatorcontrib><creatorcontrib>Veasy, L. George, MD</creatorcontrib><creatorcontrib>Bale, James F., MD</creatorcontrib><title>Rheumatic Chorea: Relationship to Systemic Manifestations and Response to Corticosteroids</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF). Study design An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through January 2002. Results Of 584 cases in the database, 537 (91%) were new-onset RF (median age of 10 years) and 177 (33%) had chorea. Patients with chorea were more often female (OR = 0.37, 95% CI = 0.25-0.55, P < .0001) and were less likely to have carditis or arthritis. Prednisone treatment may lead to a shortened course of chorea (4.0 weeks in prednisone-treated [n = 32] vs 9.0 weeks in untreated [n = 14]; P < .0001). Among 33 patients seen at a median of 10.3 years (range 6.3-14.9 years) after their initial bout of chorea, 20% reported residual tremor or mood swings. Ten of the 33 (30%) had one or more recurrences of chorea. Conclusions Chorea affected one-third of the children with RF. Patients with chorea were less likely to have severe cardiac or rheumatologic complications of RF. Therapy with prednisone shortened the duration of rheumatic chorea; some reported recurrences of chorea and had minor neurologic sequelae.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chorea - drug therapy</subject><subject>Chorea - etiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Pediatrics</subject><subject>Prednisone - therapeutic use</subject><subject>Rheumatic Fever - complications</subject><subject>Risk Factors</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV2L1TAQhoso7nH1FwjSG71rnXw0aQUFOawfsCLs6oVXIU0nnNS26SatcP79pp4DC954NQl5ZvLyTJa9JFASIOJtX_YzdrGkALIEXkLVPMp2BBpZiJqxx9kOgNKCcSkusmcx9gDQcICn2QWpgVWkYrvs180B11EvzuT7gw-o3-U3OKS7n-LBzfni89tjXHBMwDc9OYtxOb3meuoSG-d0xo3b-5DG-AQH77r4PHti9RDxxbleZj8_Xf3Yfymuv3_-uv94XRjO6VJUyDtLZYtoOa2hxRpp0wqoUUNLZSUMsTYVjqaTknS2llZ2tiVWsNZwyS6zN6e5c_B3a4qnRhcNDoOe0K9RibpikguaQHYCTfAxBrRqDm7U4agIqM2o6tVfo2ozqoCrZDR1vTqPX9sRu4ees8IEvD4DOho92KAn4-ID1zQghdhyvj9xmGT8cRhUNA4ng50LaBbVefefIB_-6TeDm1z68jceMfZ-DVPyrIiKVIG63Za_7R4kAAfWsHtpF6vr</recordid><startdate>20071201</startdate><enddate>20071201</enddate><creator>Walker, Adrianne R., MD</creator><creator>Tani, Lloyd Y., MD</creator><creator>Thompson, Joel A., MD</creator><creator>Firth, Sean D., PhD, MPH</creator><creator>Veasy, L. George, MD</creator><creator>Bale, James F., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20071201</creationdate><title>Rheumatic Chorea: Relationship to Systemic Manifestations and Response to Corticosteroids</title><author>Walker, Adrianne R., MD ; Tani, Lloyd Y., MD ; Thompson, Joel A., MD ; Firth, Sean D., PhD, MPH ; Veasy, L. George, MD ; Bale, James F., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-5e4df27beef4280be8e29b608ea0b2756c1ff7564ecd771df87f7dfb1f63bc473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chorea - drug therapy</topic><topic>Chorea - etiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Pediatrics</topic><topic>Prednisone - therapeutic use</topic><topic>Rheumatic Fever - complications</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walker, Adrianne R., MD</creatorcontrib><creatorcontrib>Tani, Lloyd Y., MD</creatorcontrib><creatorcontrib>Thompson, Joel A., MD</creatorcontrib><creatorcontrib>Firth, Sean D., PhD, MPH</creatorcontrib><creatorcontrib>Veasy, L. George, MD</creatorcontrib><creatorcontrib>Bale, James F., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walker, Adrianne R., MD</au><au>Tani, Lloyd Y., MD</au><au>Thompson, Joel A., MD</au><au>Firth, Sean D., PhD, MPH</au><au>Veasy, L. George, MD</au><au>Bale, James F., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rheumatic Chorea: Relationship to Systemic Manifestations and Response to Corticosteroids</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2007-12-01</date><risdate>2007</risdate><volume>151</volume><issue>6</issue><spage>679</spage><epage>683</epage><pages>679-683</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>Objective To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF). Study design An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through January 2002. Results Of 584 cases in the database, 537 (91%) were new-onset RF (median age of 10 years) and 177 (33%) had chorea. Patients with chorea were more often female (OR = 0.37, 95% CI = 0.25-0.55, P < .0001) and were less likely to have carditis or arthritis. Prednisone treatment may lead to a shortened course of chorea (4.0 weeks in prednisone-treated [n = 32] vs 9.0 weeks in untreated [n = 14]; P < .0001). Among 33 patients seen at a median of 10.3 years (range 6.3-14.9 years) after their initial bout of chorea, 20% reported residual tremor or mood swings. Ten of the 33 (30%) had one or more recurrences of chorea. Conclusions Chorea affected one-third of the children with RF. Patients with chorea were less likely to have severe cardiac or rheumatologic complications of RF. Therapy with prednisone shortened the duration of rheumatic chorea; some reported recurrences of chorea and had minor neurologic sequelae.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>18035153</pmid><doi>10.1016/j.jpeds.2007.04.059</doi><tpages>5</tpages></addata></record> |
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subjects | Adolescent Adult Biological and medical sciences Child Child, Preschool Chorea - drug therapy Chorea - etiology Female General aspects Glucocorticoids - therapeutic use Humans Male Medical sciences Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Pediatrics Prednisone - therapeutic use Rheumatic Fever - complications Risk Factors |
title | Rheumatic Chorea: Relationship to Systemic Manifestations and Response to Corticosteroids |
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