Acute rheumatic fever
ICD-10 I00 · ICD-11 1B40

Acute Rheumatic Fever with Sydenham Chorea

Sydenham chorea is a neuropsychiatric manifestation of acute rheumatic fever (ARF) that adds a distinct treatment dimension to the clinical picture.

Clinical scenario

Sydenham chorea is characterised variably by chorea, decreased muscle tone, and in some cases psychiatric and behavioural symptoms such as obsessive-compulsive symptoms and hyperactivity. When it complicates ARF, it requires specific consideration alongside standard rheumatic fever management.

Treatment approach — partial overview

In very unwell children, or where chorea does not respond to initial measures, escalation to immunotherapy may be warranted. Specific immunotherapeutic interventions are available as part of the structured protocol.

Full regimen, sequencing, and dosing details available in the complete protocol below.
Instant Access to Structured Evidence-Based Regimens

References

  1. Sydenham chorea is a neuropsychiatric manifestation of ARF characterised variably by chorea, decreased muscle tone, and in some cases, psychiatric and behavioural symptoms such as obsessive-compulsive symptoms and hyperactivity.
  2. In very unwell children, consideration is needed of intravenous immunoglobulin or plasma exchange.
  3. Intravenous immunoglobulin 2 g/kg over 5 to 7 days.
  4. Plasmapheresis e.g. for 5 days.
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