Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series.
AIM: Sydenham chorea is an immune-mediated neuropsychiatric condition, and a major criterion for diagnosis of acute rheumatic fever (ARF). Children in remote Northern Australia experience disproportionately high rates of ARF, yet studies looking at the epidemiology, clinical presentation and managem...
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ftnorthernterhls:oai:digitallibrary.health.nt.gov.au:10137/12520 2023-09-05T13:19:28+02:00 Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. Soller T Roberts K V Middleton B F Ralph A P 2023-08-17 https://hdl.handle.net/10137/12520 https://doi.org/10.1111/jpc.16481 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/37589435 eng eng Australia © 2023 Paediatrics and Child Health Division (The Royal Australasian College of Physicians). J Paediatr Child Health. 2023 Aug 17. doi:10.1111/jpc.16481. 9005421 https://hdl.handle.net/10137/12520 Journal of paediatrics and child health doi:10.1111/jpc.16481 orcid:0000-0001-7189-9541 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/37589435 Journal Article 2023 ftnorthernterhls https://doi.org/10.1111/jpc.16481 2023-08-21T22:16:02Z AIM: Sydenham chorea is an immune-mediated neuropsychiatric condition, and a major criterion for diagnosis of acute rheumatic fever (ARF). Children in remote Northern Australia experience disproportionately high rates of ARF, yet studies looking at the epidemiology, clinical presentation and management of Sydenham chorea are limited in this population. METHODS: We conducted a retrospective case series from January 2002 to April 2022 of all paediatric patients aged ≤18 years admitted to Royal Darwin Hospital with Sydenham chorea. Cases were identified using the hospital's clinical coding system (ICD10). Medical records were reviewed and data on demographics, clinical presentation, investigation results, treatment and outcome were extracted, deidentified and analysed. RESULTS: One hundred ten presentations of Sydenham chorea occurred between 2002 and 2022, 109 (99%) of these were in First Nations children, with 85% residing in very remote locations. Most commonly, chorea presented as a generalised movement disorder affecting all four limbs (49%). Neuropsychiatric symptoms were reported in 33 (30%), and there was evidence of rheumatic heart disease on echocardiogram in 86 (78%) at presentation. All patients received benzathine penicillin, but there was significant variation in management of chorea, ranging from supportive management, to symptomatic management with anticonvulsants, to immunomodulatory medications including corticosteroids. CONCLUSION: This case series highlights the significant burden of Sydenham chorea among First Nations children living in Northern Australia and demonstrates wide variation in treatment approaches. High-quality clinical trials are required to determine the best treatment for this disabling condition. Paediatric Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia. Global Health Division, Menzies School of Health Research, John Mathews Building Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia. Article in Journal/Newspaper First Nations Northern Territory Government Health Library Services ePublications Menzies ENVELOPE(61.911,61.911,-73.437,-73.437) Journal of Paediatrics and Child Health |
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Open Polar |
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Northern Territory Government Health Library Services ePublications |
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ftnorthernterhls |
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English |
description |
AIM: Sydenham chorea is an immune-mediated neuropsychiatric condition, and a major criterion for diagnosis of acute rheumatic fever (ARF). Children in remote Northern Australia experience disproportionately high rates of ARF, yet studies looking at the epidemiology, clinical presentation and management of Sydenham chorea are limited in this population. METHODS: We conducted a retrospective case series from January 2002 to April 2022 of all paediatric patients aged ≤18 years admitted to Royal Darwin Hospital with Sydenham chorea. Cases were identified using the hospital's clinical coding system (ICD10). Medical records were reviewed and data on demographics, clinical presentation, investigation results, treatment and outcome were extracted, deidentified and analysed. RESULTS: One hundred ten presentations of Sydenham chorea occurred between 2002 and 2022, 109 (99%) of these were in First Nations children, with 85% residing in very remote locations. Most commonly, chorea presented as a generalised movement disorder affecting all four limbs (49%). Neuropsychiatric symptoms were reported in 33 (30%), and there was evidence of rheumatic heart disease on echocardiogram in 86 (78%) at presentation. All patients received benzathine penicillin, but there was significant variation in management of chorea, ranging from supportive management, to symptomatic management with anticonvulsants, to immunomodulatory medications including corticosteroids. CONCLUSION: This case series highlights the significant burden of Sydenham chorea among First Nations children living in Northern Australia and demonstrates wide variation in treatment approaches. High-quality clinical trials are required to determine the best treatment for this disabling condition. Paediatric Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia. Global Health Division, Menzies School of Health Research, John Mathews Building Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia. |
format |
Article in Journal/Newspaper |
author |
Soller T Roberts K V Middleton B F Ralph A P |
spellingShingle |
Soller T Roberts K V Middleton B F Ralph A P Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
author_facet |
Soller T Roberts K V Middleton B F Ralph A P |
author_sort |
Soller T |
title |
Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
title_short |
Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
title_full |
Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
title_fullStr |
Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
title_full_unstemmed |
Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series. |
title_sort |
sydenham chorea in the top end of australia's northern territory: a 20-year retrospective case series. |
publisher |
Australia |
publishDate |
2023 |
url |
https://hdl.handle.net/10137/12520 https://doi.org/10.1111/jpc.16481 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/37589435 |
long_lat |
ENVELOPE(61.911,61.911,-73.437,-73.437) |
geographic |
Menzies |
geographic_facet |
Menzies |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
© 2023 Paediatrics and Child Health Division (The Royal Australasian College of Physicians). J Paediatr Child Health. 2023 Aug 17. doi:10.1111/jpc.16481. 9005421 https://hdl.handle.net/10137/12520 Journal of paediatrics and child health doi:10.1111/jpc.16481 orcid:0000-0001-7189-9541 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/37589435 |
op_doi |
https://doi.org/10.1111/jpc.16481 |
container_title |
Journal of Paediatrics and Child Health |
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1776200264203632640 |