Sydenham Chorea with Elevated Interleukin-12 Levels Responsive to Plasmapheresis and Immunotherapy: Case Report

Abstract Introduction Sydenham chorea (SC) presents with random abnormal involuntary movements that occur after an autoimmune reaction to prior group A beta-hemolytic Streptococcal infection. While most cases resolve spontaneously, there are cases with prolonged duration of symptoms and recurrences. Case report A 22-year-old woman presented with a 2-month history of involuntary, brief, random, and irregular movements of the limbs. She had a history of multiple streptococcal throat infections. At age 2 years old, she had scarlet fever. After ruling out other causes of her chorea, she was diagnosed with Sydenham chorea. She received intravenous immunoglobulin as well as oral prednisone and amantadine with full resolution of her symptoms. Conclusion Interleukin-12 was elevated approximately seven months after hospital discharge which is different from previously published findings of elevation only in acute phase of the disease. Intensive immunosuppressive treatment during the acute phase and adherence to antibiotic treatment could have contributed to the full resolution of her chorea.