Abstract
The objective of the present study was to determine whether brain single-photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities. Ten Sydenham's chorea (SC) patients, eight females and two males, 8 to 25 years of age (mean 13.4), with a clinical diagnosis of SC were submitted to brain SPECT imaging. We used HMPAO labeled with technetium-99m at a dose of 740 MBq. Six examinations revealed hyperperfusion of the basal ganglia, while the remaining four were normal. The six patients with abnormal results were females and their data were not correlated with severity of symptoms. Patients with abnormal brain SPECT had a more recent onset of symptoms (mean of 49 days) compared to those with normal SPECT (mean of 85 days) but this difference did not reach statistical significance. Brain SPECT can be a helpful method to determine abnormalities of the basal ganglia in SC patients but further studies on a larger number of patients are needed in order to detect the phase of the disease during which the examination is more sensitive.
Highlights
Sydenhams chorea (SC) has been known since the middle ages, but its relationship with rheumatic fever was established only in the 19th century [1]
The objective of the present study was to determine whether brain single-photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities
Ten Sydenhams chorea (SC) patients, eight females and two males, 8 to 25 years of age, with a clinical diagnosis of SC were submitted to brain SPECT imaging
Summary
Sydenhams chorea (SC) has been known since the middle ages, but its relationship with rheumatic fever was established only in the 19th century [1]. According to Jones criteria [2], it is currently considered as a major manifestation of rheumatic fever. In 80% of cases, SC mainly affects children and adolescents, occurrence in young adults is not rare [3,4]. In 1948 a relationship was established between rheumatic fever and the infection caused by the beta-hemolytic streptococcus of group A [5]. There is evidence that the immune system plays a role in the pathogenesis of the disease by producing antibodies against the subthalamic and caudate nuclei [6]. High levels of IgG are found in cerebrospinal fluid during the acute phase of the disease [7]
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