Clinical and Paraclinical Findings of Sydenham Chorea in Pediatric Patients

Background: Rheumatic fever and Sydenham chorea rarely occur in developed countries, but are still one of the major public health problems among children and adolescents in many developing countries. Cause of differences in clinical manifestations of the disease in the regions and the impact of this disease on people s life quality, evaluating the demographic, clinical and paraclinical findings of the disease can be helpful in improving therapeutic measures. Methods: This study was performed retrospectively on 22 patients diagnosed with Sydenham chorea between 1385 to 1395. Check list was designed and the following data were gathered from medical records of patients: age, sex, initial complaint, clinical signs of rheumatic fever, clinical signs and symptoms of Sydenham chorea, laboratory data, ECG, EEG, echocardiography and brain MRI findings. The data obtained from the medical records was analyzed.Results: Of the 22 patients studied, 8 patients were male and 14 were female. The mean age of patients was 10.09 years. The highest number of patients was in subgroups of 10-12 and 7-9 years old. In 31.8% of patients, Chorea was the only symptom of rheumatic fever. Chorea was bilateral in 68.2% of patients while in 18.2% it was unilateral. The most clinical findings in patients were jerk movements, facial grimacing gait disturbance, facial grimacing, psychiatric disorders, speech problems, muscle weakness, milkmaid grip sign, lingual dyskinesia, fever, pronator sign, and babinski .in 23.8% of patients the auscultation of the heart had a holosystolic murmur. In laboratory tests, ESR was positive in 50% of patients, 31.2% of the patients had positive CRP and ASO was positive in 53.3% of the patients. ECG was performed for 21 patients, none of them had pathological findings.findings in Echocardiography were MR (63.6%), AR (45.5%), TR (22.7%), PR (4.5%%), and Effusion (5.4%). Conclusions: The results of this study showed that Sydenham chorea can be the only symptom of rheumatic fever, and attention to clinical symptoms such as jerk movements, gait disorders and facial grimacing is important for diagnosis of the disease. The disease often occurs between the ages of 7 to 12 years. among laboratory test, ESR, CRP and ASO can be helpful in diagnosis of the disease.