Muhammad Shahid, Junaid Rashid, Muhammad Tariq Bhatti, Faiqa Saleem Baig, Muzaffer Ali, Mamoon Ahmed.
Clinical features of rheumatic chorea in children.
Pak Paed J Jan ;34(4):208-12.

Objective: To describe the clinical features of Rheumatic chorea in children Study Design: Hospital based prospective Descriptive study Setting: Pediatric department, Jinnah Hospital Lahore. Duration of study: 15th October 2008 to 15th June 2010. Sample Size: 18 patients with clinical features of chorea. Methods: 18 patients with clinical features of chorea of less than 15 years of age who presented sequentially were studied during this period. Results: Out of 18 patients of chorea 61% were females and 39% male with female : male ratio of 1.5:1. Minimum age of the patient was 6 years and maximum of 12 with mean and mode of 11 years. 66.7 % children were having generalised chorea, 22.2% with right sided hemichorea, 5.6% with left sided hemichorea and 5.6% with left sided monochorea. 44.4% of patients were having emotional/behavioural disturbance. Speech disturbance was observed in 72.2% of the total patients. Among the clinical signs of chorea, Milkmaid Sign was present in 68.3%, Darting Tongue in 56.3%, Pronator Sign in 24% and Spooning in 43.8% of patients. Regarding other manifestations of rheumatic fever one patient (5.6%) had evidence of Carditis with moderate mitral regurgitation. Evidence of recent streptococcal infection i.e raised ASO titer was present in 33.3% of patients. Conclusions: Rheumatic chorea is the commonest form of chorea in children. Diagnosis of Rheumatic chorea in children is almost always clinical. Rheumatic chorea often is seen in pure form without arthritis or carditis. Evidence of recent streptococcal infection, will may not be found in most of cases. No laboratory test can confirm the diagnosis.

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