Pregnancy in patients with Sydenham鈥檚 Chorea

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• 作者：Dé ; bora P. Maia ; Patricia G. Fonseca ; Sarah T. Camargos ; Clá ; udia Pfannes ; Mauro C. Cunningham ; Francisco Cardoso ; ^{cardosofe@terra.com.br}
• 关键词：Chorea ; Chorea gravidarum ; Sydenham&rsquo ; s Chorea ; Rheumatic fever ; Pregnancy
• 刊名：Parkinsonism and Related Disorders
• 出版年：2012
• 期刊代码：215_13538020
• 类别：med
• 出版时间：June, 2012
• 卷：18
• 期：5
• 页码：458-461
• 文件大小：116 K

摘要

Background

Sydenham鈥檚 Chorea is a frequent cause of chorea during pregnancy, chorea gravidarum. The aim of this article is to describe the effect of pregnancy in a consecutive series of patients with diagnosis of Sydenham鈥檚 Chorea.

Methods

A chart review was performed of all patients with the diagnosis of Sydenham鈥檚 Chorea followed up at our institution from 07/1993 through 08/2010 and who became pregnant.

Results

From 66 patients, 20 became pregnant. Of these 20 patients, 15 (75%) developed chorea gravidarum. Generalized chorea was found in 67%of these 15 patients, focal or multifocal chorea was identified in 20%and 13.4%developed hemichorea. In 80%of cases chorea began in the first 6 months of gestation. Three women with previous persistent chorea experienced worsening of the movement disorder during pregnancy. Remission occurred after delivery in 11 patients whereas the other four remained with non-disabling chorea during the first 12 months after delivery. Abortion occurred in two patients (13%). All patients with chorea gravidarum subsequently treated with oral contraceptives developed recurrence of chorea.

Conclusions

Chorea gravidarum is a frequent complication of pregnancy in patients with previous history of Sydenham鈥檚 Chorea and an increased risk of miscarriage should be considered. Our findings confirm the notion that chorea gravidarum results from hormonal changes acting on previously dysfunctional basal ganglia.