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Long-term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies§

Authors

  • Peggy Reiner MD,

    Corresponding author
    1. Service de Neurologie, AP-HP, Hôpital Lariboisière, Paris, France
    • Service de Neurologie, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France
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  • Damien Galanaud MD, PhD,

    1. Service de Neuroradiologie, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Gaëlle Leroux MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Marie Vidailhet MD,

    1. Fédération des Maladies du Système Nerveux Central, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Julien Haroche MD, PhD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Du Le Thi Huong MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Camille Francès MD,

    1. Service de Dermatologie, Hôpital Tenon, AP-HP, Paris, France
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  • Thomas Papo MD,

    1. Service de Médecine Interne, AP-HP, Hôpital Bichat, Paris, France
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  • Christian de Gennes MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Lucile Musset MD, PhD,

    1. Service d'Immunochimie, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Bertrand Wechsler MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Zahir Amoura MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Jean-Charles Piette MD,

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Nathalie Costedoat-Chalumeau MD, PhD

    1. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, AP-HP, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France
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  • Funding agencies: This work received no financial support.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles can be found in the online version of this article.

Abstract

Objective:

The aim of this work was to describe chorea during systemic lupus erythematosus or antiphospholipid antibodies and its long-term outcome.

Methods:

We retrospectively analyzed clinical features, laboratory findings, imaging characteristics, and outcome in a series of 32 patients.

Results:

Most patients were women (28 of 32), and mean age at onset of chorea was 20.6 (9–62) years. Chorea was inaugural for 28 patients. Improvement was observed with various treatments. During follow-up (12.2 ± 11.3 years), severe manifestations of systemic lupus erythematosus were rare. Antiphospholipid antibodies were repeatedly positive for 90% of the patients. Twelve patients developed arterial thrombosis. Prophylactic treatment with antithrombotic therapy might reduce the risk of further thrombosis (8% versus 57%; P = 0.01). Cardiac valvulopathy occurred in 22 patients during follow-up. Chorea relapsed in 8 cases.

Conclusions:

Chorea had a good outcome in itself. This long-term follow-up shows, for the first time, that these patients have substantial risk for further arterial thrombosis. © 2011 Movement Disorder Society

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