Inmunoglobulina en el tratamiento de corea de Sydenham

	Eur J Pediatr. 2010 Sep;169(9):1151-4. Epub 2010 Mar 30. Beneficial use of immunoglobulins in the treatment of Sydenham chorea. van Immerzeel TD, van Gilst RM, Hartwig NG. Source Paediatric Department, Van Weel Bethesda Ziekenhuis, Stationsweg 22, 3247 BW Dirksland, The Netherlands. tabithakieviet@gmail.com Abstract This double case report indicates that treatment with intravenous immunoglobulins (IVIG) is effective in patients with Sydenham chorea (SC). SC is a rare but impressive clinical manifestation following streptococcal infection. This movement disorder characterised by chorea, emotional lability and muscle weakness, is one of the major criteria of acute rheumatic fever. Treatment of SC is typically limited to supportive care and palliative medications. Curative treatment is still in the experimental stage. Recent research on patients with SC proved that antibodies against the group A streptococcus cross-react with epitopes of neurons in the basal ganglia, namely, intracellular tubulin and extracellular lysoganglioside. Therefore, immune modulating therapy by means of prednisone, plasma exchange and IVIG are mentioned in the literature as possible effective treatment. Beneficial effect of IVIG has been shown in several diseases with molecular mimicry as the underlying pathophysiology. In this paper, we describe two girls aged 11 and 13 years, respectively, who presented with SC having severe disabilities in their daily live. We treated both patients with IVIG 400 mg/kg/day for 5 days. Treatment was tolerated well and had a pronounced positive effect. Shortly after the drug was administered, all signs and symptoms disappeared in both patients. Based upon these patients, we highlight IVIG as a serious treatment option for SC. PMCID: PMC2908459 Free PMC Article
	PMID: 20349351 [PubMed - indexed for MEDLINE]
	Publication Types Case Reports MeSH Terms Chorea/drug therapy*, Chorea/immunology, Immunoglobulins, Intravenous/administration & dosage*, Rheumatic Fever/complications*, Severity of Illness Index, Treatment Outcome