Neurologic and Cardiac Findings in Children With Sydenham Chorea

This study investigated the association between cardiac and neurologic findings and the long-term prognosis in Sydenham chorea. A retrospective, descriptive study was conducted with 40 patients between 1991 and 2004. Their age, gender, clinical findings, severity of disease, presence of carditis, and neurological findings were evaluated. Patients were predominantly female (70%), and the mean age was 11.3 ± 2.5 years. The mean duration of chorea was 5.3 ± 3.1 months (range, 1-12 months). Chorea was mild in 30 patients, moderate in 9, and severe in 1. Carditis was confirmed by echocardiography in 28 cases (70%); the most frequently involved valve was the mitral (35%). Duration of chorea in patients with carditis did not differ significantly from that in patients without carditis. Mean follow-up time was 2.6 ± 1.5 years. Acute flaring of acute rheumatic fever did not recur in any patient taking penicillin prophylactically. No patient had persistent chorea. Although murmurs in patients with Sydenham chorea predicts carditis with high probability, the absence of murmur does not exclude it. In patients with carditis, the mitral valve is the one most frequently involved.