Managing and treating Sydenham chorea: A systematic review
Abstract Introduction Sydenham's chorea (SC), prevalent in developing countries and occasionally affecting developed ones, poses a clinical challenge due to the lack of systematic guidelines for diagnosis and treatment. Resulting from Group A Beta‐Hemolytic Streptococcus infection, SC presents...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-06-01
|
| Series: | Brain and Behavior |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/brb3.3035 |
| _version_ | 1811153962734190592 |
|---|---|
| author | Samiuddin Tariq Faizan Niaz Summaiyya Waseem Taha Gul Shaikh Syed Hassan Ahmed Muhammad Irfan Abdulqadir J. Nashwan Irfan Ullah |
| author_facet | Samiuddin Tariq Faizan Niaz Summaiyya Waseem Taha Gul Shaikh Syed Hassan Ahmed Muhammad Irfan Abdulqadir J. Nashwan Irfan Ullah |
| author_sort | Samiuddin Tariq |
| collection | DOAJ |
| description | Abstract Introduction Sydenham's chorea (SC), prevalent in developing countries and occasionally affecting developed ones, poses a clinical challenge due to the lack of systematic guidelines for diagnosis and treatment. Resulting from Group A Beta‐Hemolytic Streptococcus infection, SC presents various symptoms. This review aims to collect and evaluate available data on SC management to propose a cohesive treatment plan. Methods We searched PubMed, the Cochrane Library, Google Scholar, and ClinicalTrials.gov for literature on SC management from inception until 24th July 2022. Studies were screened by titles and abstracts. Cochrane Collaboration's Risk of Bias tool (RoB‐1) assessed Randomized Controlled Trials, while the Risk of Bias In Non‐randomized Studies of Interventions (ROBINS‐I) tool evaluated nonrandomized studies. Results The review includes 11 articles assessing 579 patients. Excluding one study with 229 patients, of the remaining 550 patients, 338 (61.5%) were females. Treatments used were dopamine antagonists in 118 patients, antiepileptics in 198, corticosteroids in 134, IVIG in 7, and PE in 8 patients. Dopamine antagonists, particularly haloperidol, were the primary treatment choice, while valproic acid (VPA) was favored among antiepileptics. Prednisolone, a corticosteroid, showed promising results with weight gain as the only side‐effect. Our review emphasizes the importance of immunomodulators in SC, contrasting previous literature. Conclusion Despite limitations, dopamine antagonists can serve as first‐line agents in SC management, followed by antiepileptics. The role of immunomodulators warrants further investigation for conclusive recommendations. |
| first_indexed | 2024-03-13T05:04:38Z |
| format | Article |
| id | doaj.art-376d6c88486c4b158fce382a42a4d9d3 |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-03-13T05:04:38Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-376d6c88486c4b158fce382a42a4d9d32023-06-16T18:11:55ZengWileyBrain and Behavior2162-32792023-06-01136n/an/a10.1002/brb3.3035Managing and treating Sydenham chorea: A systematic reviewSamiuddin Tariq0Faizan Niaz1Summaiyya Waseem2Taha Gul Shaikh3Syed Hassan Ahmed4Muhammad Irfan5Abdulqadir J. Nashwan6Irfan Ullah7Dow Medical College Dow University of Health Sciences Karachi PakistanDow Medical College Dow University of Health Sciences Karachi PakistanDow Medical College Dow University of Health Sciences Karachi PakistanDow Medical College Dow University of Health Sciences Karachi PakistanDow Medical College Dow University of Health Sciences Karachi PakistanDepartment of Internal Medicine Wellstar Health System Spalding Hospital Griffin Georgia USAHamad Medical Corporation Doha QatarKabir Medical College Gandhara University Peshawar Khyber Pakhtunkhkwa PakistanAbstract Introduction Sydenham's chorea (SC), prevalent in developing countries and occasionally affecting developed ones, poses a clinical challenge due to the lack of systematic guidelines for diagnosis and treatment. Resulting from Group A Beta‐Hemolytic Streptococcus infection, SC presents various symptoms. This review aims to collect and evaluate available data on SC management to propose a cohesive treatment plan. Methods We searched PubMed, the Cochrane Library, Google Scholar, and ClinicalTrials.gov for literature on SC management from inception until 24th July 2022. Studies were screened by titles and abstracts. Cochrane Collaboration's Risk of Bias tool (RoB‐1) assessed Randomized Controlled Trials, while the Risk of Bias In Non‐randomized Studies of Interventions (ROBINS‐I) tool evaluated nonrandomized studies. Results The review includes 11 articles assessing 579 patients. Excluding one study with 229 patients, of the remaining 550 patients, 338 (61.5%) were females. Treatments used were dopamine antagonists in 118 patients, antiepileptics in 198, corticosteroids in 134, IVIG in 7, and PE in 8 patients. Dopamine antagonists, particularly haloperidol, were the primary treatment choice, while valproic acid (VPA) was favored among antiepileptics. Prednisolone, a corticosteroid, showed promising results with weight gain as the only side‐effect. Our review emphasizes the importance of immunomodulators in SC, contrasting previous literature. Conclusion Despite limitations, dopamine antagonists can serve as first‐line agents in SC management, followed by antiepileptics. The role of immunomodulators warrants further investigation for conclusive recommendations.https://doi.org/10.1002/brb3.3035Sydenham's choreagroup a beta‐hemolytic Streptococcusgamma‐aminobutyric acidacute rheumatic fever |
| spellingShingle | Samiuddin Tariq Faizan Niaz Summaiyya Waseem Taha Gul Shaikh Syed Hassan Ahmed Muhammad Irfan Abdulqadir J. Nashwan Irfan Ullah Managing and treating Sydenham chorea: A systematic review Brain and Behavior Sydenham's chorea group a beta‐hemolytic Streptococcus gamma‐aminobutyric acid acute rheumatic fever |
| title | Managing and treating Sydenham chorea: A systematic review |
| title_full | Managing and treating Sydenham chorea: A systematic review |
| title_fullStr | Managing and treating Sydenham chorea: A systematic review |
| title_full_unstemmed | Managing and treating Sydenham chorea: A systematic review |
| title_short | Managing and treating Sydenham chorea: A systematic review |
| title_sort | managing and treating sydenham chorea a systematic review |
| topic | Sydenham's chorea group a beta‐hemolytic Streptococcus gamma‐aminobutyric acid acute rheumatic fever |
| url | https://doi.org/10.1002/brb3.3035 |
| work_keys_str_mv | AT samiuddintariq managingandtreatingsydenhamchoreaasystematicreview AT faizanniaz managingandtreatingsydenhamchoreaasystematicreview AT summaiyyawaseem managingandtreatingsydenhamchoreaasystematicreview AT tahagulshaikh managingandtreatingsydenhamchoreaasystematicreview AT syedhassanahmed managingandtreatingsydenhamchoreaasystematicreview AT muhammadirfan managingandtreatingsydenhamchoreaasystematicreview AT abdulqadirjnashwan managingandtreatingsydenhamchoreaasystematicreview AT irfanullah managingandtreatingsydenhamchoreaasystematicreview |