To the Editor.
—The article on Sydenham's chorea1 was a well-timed reminder of a potentially serious complication of inadequately diagnosed streptococcal infection. Physicians need to be aware of this issue.However, I was concerned that the detailed results of a patient who was part of a randomized, comparative treatment trial that had not been reported were used as an anecdotal case report. Dr Swedo also reported this case as part of the Grand Rounds from which the article was drawn.Prudence and good science suggest that a report of a single patient should not be published before publication of the entire study from which this patient was drawn. If the author believes that plasmapheresis is a better therapy than the comparators, intravenous immunoglobulin and prednisone, patients should not be randomly allocated to presumptively inferior treatments. If the issue needs resolution by a clinical trial, positive results of a single
Jaffe ME. Sydenham's Chorea. JAMA. 1995;274(4):304. doi:10.1001/jama.1995.03530040030033