Chorea as an Initial Manifestation of Systemic Lupus Erythematosus

Abstract

Neurological complications of systemic lupus erythematosus (SLE) are relatively common, but isolated chorea as the initial manifestation of SLE is very rare. We report a 10-year-old girl presenting with chorea, who developed clinical and laboratory findings of SLE 10 months after the onset of chorea. In this case, mild depression of complement levels in serum, which had already been found in the early stage of the chorea, was the only abnormal laboratory datum. The low serum complement levels that precede the appearance of other clinical and laboratory findings may be helpful for the diagnosis of isolated chorea involvement in SLE.

A Rare Presentation of Systemic Lupus Erythematosus during Childhood: Chorea

“…Many studies have described a close relationship between chorea that is seen in patients with SLE and antiphospholipid antibodies (1,2,7,8). In our case, antiphospholipid antibodies tested negative.…”

Treatment of Chorea in Childhood

“…Haloperidol has been reported to be effective in various other types of chorea including APS, SLE, and postpump chorea. [31][32][33] Potential extrapyramidal side effects of haloperidol explain why reports of haloperidol use in childhood chorea were mainly published before 2000. Despite the disadvantages, given its efficacy for chorea, haloperidol should still be considered an option for treating childhood chorea particularly in resistant cases.…”

Chorea Associated with High Titers of Antiphospholipid Antibodies in the Absence of Antiphospholipid Antibody Syndrome

“…11 APS is a hypercoagulable state characterized by the presence of at least one of the following clinical criteria of vascular thrombosis or pregnancy morbidity, in addition to the presence of one of the following antibodies: lupus anticoagulant (LAC or LA), anticardiolipin (aCL), or anti-b2 glycoprotein-I antibody (ab2GPI). 12 Chorea is reported in 4% of the patients with lupus erythematosus 13,14 and can be the first manifestation of lupus in children [15][16][17] or even in late-onset SLE. 18 The aCL antibody is the most frequently detected type of aPL antibodies in SLE, while LAC is the most frequent in SLE patients with chorea.…”