Hemichorea with antiphospholipid antibodies in a patient with systemic lupus erythematosus

Brochado, Ana Vide; Pimenta, Sofia; Silva, Marta; Sousa, Raquel; Campos, Maria Manuel; Brito, Iva

doi:10.1136/bcr.12.2008.1339

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…Chorea can occur in APS with or without association with SLE [ 90 92 ]. Although SLE can independently cause chorea [ 93 ] it is more frequently associated with positive antiphospholipid titers, even if the patient previously tested negative for APS [ 94 ].…”

Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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Background: Chorea can be due to a large number of etiologies. Unilateral chorea is classically related to a contralateral structural lesion, e.g. of the putamen or subthalamic nucleus, however, based upon personal impressions, we have observed that systemic disease, in particular metabolic or autoimmune conditions, can also lead to a unilateral or markedly asymmetric presentations. We sought to investigate this impression by reviewing the literature. Methods: A PubMed search was conducted using the terms asymmetric” AND “chorea” OR “hemichorea” OR “unilateral” AND “chorea” OR “monochorea” OR “right greater than left” AND “chorea” OR “left greater than right” AND “chorea” OR “right more than left” AND “chorea” OR “left more than right” AND “chorea” as well as “hemiballismus” NOT “stroke” NOT “infarct” NOT “dyskinesia. A total of 243 sources were felt to meet criteria and were reviewed. Results: The most common etiology of reported hemi- or asymmetric chorea was diabetic non-ketotic hyperglycemic hemichorea/hemiballismus. Other common diagnoses were Sydenham’s disease, antiphospholipid syndrome and drug-induced chorea. The vast majority of patients with hemi- or asymmetric chorea had acquired rather than genetic, degenerative or congenital causes. Conclusion: Despite the potential limitations of our literature review, the evidence presented here supports the observation that the vast majority of asymmetric or unilateral chorea presentations are due to acquired causes, and in this situation an exhaustive search for reversible etiology should be undertaken. However, presentation with symmetric, generalized chorea does not exclude reversible causes, and investigations should address these in addition to genetic and neurodegenerative etiologies.

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Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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“…The mechanism underlying this recurrence or, more specifically, the fluctuation of antiphospholipid titers remains unclear. In extant case reports, the recurrent chorea observed in most patients with SLE appeared to be presented unilaterally 11,15–17 . We postulate that the characteristic features of chorea and the frequency of its recurrence might be related.…”

Section: Discussionmentioning

confidence: 75%

“…In extant case reports, the recurrent chorea observed in most patients with SLE appeared to be presented unilaterally. 11,[15][16][17] We postulate that the characteristic features of chorea and the frequency of its recurrence might be related. Because reports discussing this matter are limited, further research is warranted to clarify the pathophysiology of chorea to effectively predict its prognosis.…”

Section: Discussionmentioning

confidence: 99%

Recurrent hemichorea in an adolescent with systemic lupus erythematosus and previous ipsilateral cerebral infarction

Yu,

Chung,

Chiou

et al. 2023

Int J of Rheum Dis

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Systemic lupus erythematosus (SLE) can present with movement disorders, among which chorea is closely associated with antiphospholipid (aPL) antibodies. Brain imaging results obtained in patients with chorea are generally inconsistent with the clinical manifestation of chorea; moreover, medical tests for hemichorea, which are expected to reveal distinct localization, may show negative findings. Herein, we present a case of a 15‐year‐old girl with SLE who had a history of left cerebral infarction; tests revealed elevated aPL levels, and she developed recurrent left hemichorea 2 years later. Brain magnetic resonance imaging (MRI) results revealed no acute lesions during each episode of involuntary movements, and an MRI perfusion scan failed to provide an explanation for the asymmetric presentation. Although various hypotheses have been proposed regarding the mechanism underlying the occurrence of chorea, some scenarios still remain unexplained. Further investigation on the pathophysiology of chorea in SLE may be warranted to clarify its prognosis.

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Hemichorea with antiphospholipid antibodies in a patient with systemic lupus erythematosus

Abstract: We present a report of a patient with systemic lupus erythematosus who subsequently developed hemichorea associated with increased anti-phospholipid antibodies values.

Cited by 2 publications

References 11 publications

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Recurrent hemichorea in an adolescent with systemic lupus erythematosus and previous ipsilateral cerebral infarction

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