We report the cases of 5 adolescents with human T lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis, acquired in all but 1 case from the mother. The first symptom in all patients was difficulty in running, which was present for many years before the final diagnosis was made. Follow-up showed an indolent progression, regardless of treatment strategy.
-Background: Rheumatic chorea (RC) has recently been linked to an antibody-mediated immune mechanism. Objective/Method: To verify if this knowledge reflected in management changes we conceived a descriptive study. Results: The medical charts of 20 children (13 females) aged 6 to 12 years (mean 8 years), diagnosed as RC from June 1996 to June 1999, were reviewed. All patients received some medical treatment. Haloperidol was the most prescribed medication (15 patients -75 %). Sulpiride, diazepam and valproate were also used as symptomatic treatment. Imune-modulating therapy with prednisone was prescribed for seven children. The shortest course of chorea (16 days) occurred in a patient treated with prednisone. Conclusion: Prednisone has been prescribed for rheumatic chorea besides the traditional symptomatic approach. A great variety of antichoreic drugs are being employed.KEY WORDS: chorea, rheumatic fever, therapy, prognosis. Conduta na coréia reumática: um estudo observacional RESUMO -Fundamentos:A patogenia da coréia reumática relaciona-se a um mecanismo imunomediado. Objetivos/Métodos: A fim de verificar se este conhecimento resultou em mudanças na terapêutica desta doença, elaborou-se um estudo descritivo. Resultados: Foram revistos os prontuários de 20 crianças (13 meninas) entre 6 e 12 anos de idade (média 8 anos), com diagnóstico de coréia reumática realizado entre Junho de 1996 e Junho de 1999. Todos pacientes utilizaram algum tipo de medicação. Haloperidol foi a substância mais prescrita (15 pacientes -75 %). Sulpiride, diazepam e ácido valpróico foram também utilizados.
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