To the Editor.—
In an article in the Archives (35:53-54, 1978), Green reported improvement after treatment with corticosteroids in the conditions of eight consecutive patients suffering from Sydenham's chorea (SC). Green suggested that the beneficial effect of corticosteroids on SC may involve alleviating "a mild inflammatory reaction of small vessels most likely involving the caudate-putamen complex." Another possibility worth consideration is that his results reflect suppression of an autoimmune mechanism. Recent work by Husby et al1 suggests that, in SC, an "antineuronal" antibody is present that reacts with the neuronal cytoplasm of human caudate. It is possible that corticosteroids, by reducing production of such an antibody, might bring about a favorable therapeutic response. If this is true, a similar approach might be considered for the treatment of Huntington's disease (HD), inasmuch as there have also been reports of an autoimmune response in this disorder.McMenemy in 19612 first
Brown WT, Sanberg PR, McGeer PL. Corticosteroids and Chorea. Arch Neurol. 1979;36(7):452–453. doi:10.1001/archneur.1979.00500430082020
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