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August 22, 1977

Chorea in Childhood Systemic Lupus Erythematosus

Author Affiliations

Ossining, NY

JAMA. 1977;238(8):855. doi:10.1001/jama.1977.03280090019010

To the Editor.—  Awareness that neurological manifestations other than seizures and psychosis can occur as the initial aspect of childhood systemic lupus erythematosus (SLE) has not been sufficiently emphasized,1 although they were not observed in the excellent study of Coleman and co-workers (237:1095-1100, 1977). The following case of acute chorea is instructive because it adds further to the clinical spectrum of childhood SLE.

Report of a Case.—  Sudden choreiform movements of the hands, mouth, tongue, and feet developed in a previously healthy 13-year-old girl. These progressed over a three-week period and were associated with slurred speech and a tendency to fall. The patient had a low grade fever, and laboratory tests confirmed the diagnosis of SLE with strongly positive antinuclear antibody, reduced complement, anemia, elevated sedimentation rate, leukopenia, and proteinuria. She was treated with haloperidol (Haldol) and corticosteroids, which resulted in clinical recovery from chorea. A computerized axial