Revisiting an immunoneuropsychiatry classic: Sydenham's chorea.

IF 3.7 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2026-04-21 DOI:10.1080/1744666X.2026.2660763

Antonio L Teixeira, Debora P Maia, Maria Carmo Pereira Nunes, Gabriel A de Erausquin, Cristian P Zeni, Aline S Miranda

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引用次数: 0

Abstract

Introduction: Sydenham chorea (SC) is the major neurologic manifestation of rheumatic fever. It is defined by characteristic involuntary movements and frequently associated with neuropsychiatric symptoms that may develop weeks or months following a Group A beta hemolytic streptococcal (GAS) infection.

Areas covered: The authors searched PubMed database for recent original studies and systematic reviews on SC pathogenesis, clinical spectrum and therapeutic approaches.

Expert opinion: Compelling evidence supports that autoantibodies targeting neuronal antigens underly the pathogenesis of SC. In the basal ganglia, autoantibodies react, among other epitopes, with dopamine type 2 (D2) receptors. The resulting dopaminergic signaling dysfunction leads to SC-related motor and neuropsychiatric symptoms. A key gap in the antibody-mediated hypothesis of SC lays on the limited understanding on how peripherally generated autoantibodies reach the basal ganglia. D2 antagonists and valproic acid are the main symptomatic therapeutic strategies for SC. The use of corticosteroids can accelerate the resolution of motor symptoms, and must be considered in severe cases, including chorea paralytica. Plasmapheresis and immunoglobulin have been considered investigational for SC.

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重温免疫神经精神病学经典：西德纳姆舞蹈病。

西德纳姆舞蹈病（SC）是风湿热的主要神经系统表现。它的定义是特征性的不自主运动，通常与a群β溶血性链球菌（GAS）感染后数周或数月出现的神经精神症状相关。涉及领域：作者检索PubMed数据库，检索最近关于SC发病机制、临床谱和治疗方法的原始研究和系统综述。专家意见：令人信服的证据支持针对神经元抗原的自身抗体是SC发病机制的基础。在基底节区，自身抗体与多巴胺2型（D2）受体以及其他表位发生反应。由此产生的多巴胺能信号功能障碍导致sc相关的运动和神经精神症状。抗体介导的SC假说的一个关键空白在于对外周产生的自身抗体如何到达基底神经节的有限理解。D2拮抗剂和丙戊酸是SC的主要对症治疗策略。皮质类固醇的使用可以加速运动症状的缓解，在严重的病例中必须考虑，包括麻痹性舞蹈病。血浆置换和免疫球蛋白被认为是对SC的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.