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Chorea in primary antiphospholipid syndrome is associated with rheumatic fever

Texto completo
Autor(es):
Appenzeller, Simone [1] ; Yeh, Steeven [2] ; Maruyama, Marcelo [2] ; Barros, Solange Murta [3] ; de Carvalho, Jozelio Freire [2]
Número total de Autores: 5
Afiliação do(s) autor(es):
[1] Univ Estadual Campinas, Fac Med, Hosp Clin, Div Rheumatol, Campinas, SP - Brazil
[2] Univ Sao Paulo, Fac Med, Hosp Clin, Div Rheumatol, BR-01246903 Sao Paulo, SP - Brazil
[3] Hosp Naval Marcilio Dias, Div Rheumatol, Rio De Janeiro, RJ - Brazil
Número total de Afiliações: 3
Tipo de documento: Artigo Científico
Fonte: RHEUMATOLOGY INTERNATIONAL; v. 32, n. 9, p. 2857-2861, 2012.
Citações Web of Science: 7
Resumo

The aim of the study is to evaluate the frequency of chorea in a cohort of primary antiphospholipid syndrome (PAPS) patients and their possible clinical and laboratory associations. The records of 88 PAPS patients, fulfilling Sapporo criteria, followed up at the rheumatology outpatient clinic, were analyzed in order to determine the frequency of chorea. Risk factors for chorea, clinical manifestations, associated comorbidities, serologic features and treatment strategies were analyzed. Eighty-eight PAPS patients were evaluated. Mean age was 40.6 +/- A 11.1 years, and 91% of them were Caucasian and 91% women. Four (4.5%) patients with chorea were identified: 2 of them (50%) had only one chorea episode and 2 (50%) had recurrent chorea. All patients had chorea onset before PAPS diagnosis. Mean age, gender and ethnical distribution were comparable in groups with or without seizures (P > 0.05). Interestingly, the comparison of the 4 PAPS patients with chorea with those without this abnormality (n = 84) demonstrated a lower BMI [21.1 (18-24.2) vs. 27.5 (17.5-40.9) kg/m(2), P = 0.049] and frequency of venous events (0 vs. 63.1%, P = 0.023) in the first group. A higher frequency of rheumatic fever (75% vs. 0, P < 0.001) and thrombocytopenia (75 vs. 21.4%, P = 0.041) was observed in PAPS individuals with chorea. Both groups were alike regarding the other clinical APS manifestations, disease duration, risk factors for cerebrovascular diseases, use of drugs and antiphospholipid antibodies (P > 0.05). This study demonstrated that 4.5% of PAPS patients had chorea, predominately before PAPS diagnosis, and this neurological abnormality was associated with rheumatic fever and thrombocytopenia. These data reinforce the need for RF diagnosis in those PAPS patients with chorea. (AU)

Processo FAPESP: 09/06049-6 - Determinação de marcadores séricos e do líquor associados a alterações estruturais e funcionais do sistema nervoso central no Lúpus eritematoso sistêmico
Beneficiário:Simone Appenzeller
Modalidade de apoio: Bolsas no Brasil - Jovens Pesquisadores
Processo FAPESP: 08/02917-0 - Determinação de marcadores séricos e do líquor associados a alterações estruturais e funcionais do sistema nervoso central no lúpus eritematoso sistêmico
Beneficiário:Simone Appenzeller
Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores