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Query: UMLS:C0008489 (chorea)
 2,102 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chorea as a manifestation of SLE is infrequent (1% of all cases of SLE). A new case is reported herein. The patient, a seventeen-year-old female, was admitted with a one-week history of choreic movements of the left half of the body and arthritis of both wrists. Biologic findings confirmed the diagnosis of SLE with presence of an antiprothrombinase circulating anticoagulant. Findings upon cerebral CT scan and magnetic resonance imaging were normal. Clinical symptoms worsened despite corticosteroids in a daily dosage of 1 mg/kg with three pulses of 800 mg methylprednisolone. High-dose neuroleptic therapy was given and three plasma exchanges were performed. A dramatic improvement in clinical symptoms and biological anomalies occurred and persisted during follow-up which now exceeds one year. The lack of MRI anomalies suggests that the pathogenesis of SLE-associated chorea involves functional neurone activation by immune complexes; the dramatic effectiveness of plasma exchanges may obviate the need for using immunosuppressant agents in patients who fail to respond to corticosteroids.
Rev Rhum Mal Osteoartic 1992 Jun
PMID:[Lupus chorea revealing. Study in magnetic resonance imaging. Success of plasma exchanges after resistance to pulsed cortisone]. 141 Dec 10

Magnetic resonance imaging (MRI) was assessed in the management of neuropsychiatric manifestations occurring in 6 SLE patients. The MRI scans were normal in 3 cases and was associated with remission of the symptoms except for a patient who experienced a chorea at the time of the examination. Abnormal MRI scans always revealed more lesions than CT scan. 2 different patterns of abnormalities seem to correspond to 2 specific disorders. In 2 patients with clinical presentation suggesting a cortical ischemia by vascular thrombosis, both MRI scans showed areas of abnormal high signal intensities located in the subcortical white matter. In one last patient, MRI scan revealed multiple focal areas of high signal intensities (on T1 weighter scans) disseminated not only in the deep white matter but also in the gray one. These lesions could be depend upon demyelinisation which may occur by a local vascular process. This serie confirm the interest of MRI in the management of SLE brain involvement as well as it points out some problem of interpretation. This suggest further comparative studies especially at the real onset and during the course of neuro-psychiatric manifestations. At last, the coronal sections may be more informative for the diagnosis and pathophysiology than the horizontal ones.
Rev Rhum Mal Osteoartic 1990 Nov
PMID:[Magnetic resonance imaging and lupus erythematosus of the nervous system]. 229 Oct 69

Since 1944, the Jones criteria for the diagnosis of acute rheumatic fever have been regularly revised to integrate technical and diagnostic innovations. Echographic and Doppler criteria, however, remain unrecognised due to valvular insufficiency in healthy subjects. The aim of this study was to determine the cardiac lesions occurring in acute rheumatic fever and the diagnostic value of Doppler echocardiography. One hundred patients with an average age of 10 years were admitted to hospital because of a first attack of acute rheumatic fever between January 1991 and September 1992. Eighty-six had articular signs, 5 had chorea, but none had cutaneous lesions. Forty-seven murmurs of mitral insufficiency (MI) and eight of aortic insufficiency (AI) were detected; 10 children had signs of cardiac failure. Conduction defects were recorded in 12 cases. Echocardiography showed 7 pericardial effusions; often, the left heart chambers were dilated without alteration of the fractional shortening. The commonest lesions of the mitral valve were thickening of the two leaflets, the reduced mobility of the posterior leaflet, the rigidity of the anterior leaflet and 2 cases of ruptured chordae tendinae. The Doppler mode showed 73 cases of MI, 26 of which were at least moderately severe. These cases of MI were commonly excentric jets behind the posterior leaflet. There were 47 cases of AI, 10 of which were at least moderately severe. If all cases of moderately severe or mild AI and MI are considered as pathological when associated with suggestive morphological valve changes, the number of cases of carditis increased from 50 without the Doppler mode to over 80 with this mode. Doppler echocardiography validated the Jones criteria in 16 children. The authors propose Doppler echocardiography criteria for the validation of carditis.
Arch Mal Coeur Vaiss 1995 Dec
PMID:[Contribution of doppler echocardiography to the diagnosis of the first attack of acute rheumatic fever]. 872 63