Chorea in systemic lupus erythematosus: association with antiphospholipid antibodies.

Abstract

SUMMARY Chorea is a rare manifestation of systemic lupus erythematosus (SLE). In this report the clinical features of two cases of chorea associated with SLE are presented. Of special interest were the raised titres of antiphospholipid antibodies in both cases. The possible pathogenic role of these antibodies is briefly discussed.

Neurological dysfunction and hyperactive behavior associated with antiphospholipid antibodies. A mouse model.

“…The hyperkinetic movements observed in APS mice are reminiscent of chorea reported in association with the presence of elevated aPL in patients (16,43), and thus may point to a defect in the functioning of the basal ganglia in APS mice.…”

Movement disorders of autoimmune origin

“…Other immunologically based diseases in which chorea has been described are systemic lupus erythematosus, primary antiphospholipid syndrome, autoimmune thyroid disease, rheumatoid arthritis, Behçet's syndrome HenochSchönlein syndrome, periarteritis nodosa, and ChurgStrauss syndrome [28, 45,48,69]. In most of these cases neurological manifestations can be accounted for by widespread microinfarcts related to destructive and proliferative changes in arterioles and capillaries.…”

Diffusion tensor imaging in patients with obstetric antiphospholipid syndrome without neuropsychiatric symptoms

“…This is not the only mechanism, however, as psychiatric or neurologic manifestations emerge in APS patients without any evidence of brain vessel occlusions on CT or MRI [22][23][24][25][26]. Indeed, there were no signs of brain abnormalities on FLAIR or T1 images in our cohort, whereas significant differences in DTI-based indices between control and APS groups were observed.…”