Chorea gravidarum in systemic lupus erythematosus.

A case of chorea gravidarum in a patient with systemic lupus erythematosus (SLE) is described. Review of the literature on chorea gravidarum suggests that SLE may be a more common cause than previously reported. Treatment of chorea gravidarum in SLE patients is discussed.

Recurrent chorea gravidarum in four pregnancies.

An Arab woman developed recurrent chorea gravidarum in all four pregnancies that went to term, and none in the three pregnancies that ended in spontaneous abortion. She also developed an acute psychosis in one of these four pregnancies. A discussion of similar cases in the literature is undertaken.

Lupus anticoagulant in pregnancy.

In a group of 10 women with circulating lupus anticoagulant 25 intrauterine deaths were previously documented in the nine multigravidae. The presence of lupus anticoagulant activity was confirmed by showing prolongation of the activated partial thromboplastin time and kaolin clotting time with failure of correction of the prolongation on incubation with normal plasma. A clinical diagnosis of systemic lupus erythematosus (SLE) was made in four women.

Chorea gravidarum. Report of a fatal case with neuropathological observations.

In a 23-year-old primigravida with no prior history of rheumatic fever, choreiform movements developed late in the third trimester, and she died in a state of hyperthermia 14 days later. Results of neuropathological examination showed, as the basis for the chorea, nerve cell loss and astrocytosis within the striatum (especially the caudate nucleus). Anaylsis of the case in conjunction with a review of the literature strongly suggests that chorea gravidarum should be regarded as a syndrome rather than a specific disease entity.

Treatment of chorea gravidarum with haloperidol.

Treatment of a case of severe chorea gravidarum with haloperidol is presented. A possible neuropharmacologic explanation of the beneficial effects of the neuroleptics, particularly haloperidol, is offered based on the dopamine antagonism of these drugs. Heightened dopaminergic activity in the striatum is postulated as the basis for the chorea.

[Chorea minor under ovulation inhibitors].

Three weeks after commencing oral contraception for the first time, a 26-year-old woman with a history of rheumatic carditis and chorea minor presented with sudden recurrence of hyperkinesis. Withdrawal of the contraceptive agent was followed by rapid remission of the hyperkinesis, which suggests a casual relationship between the contraceptive and this condition and an analogy between this case and so-called chorea gravidarum. A young non-pregnant woman presenting with chorea minor should be specifically questioned by ingestion of oral contraceptives.

Chorea and the oral contraceptives.

The case histories are reported of six women who developed chorea while taking oral contraceptive drugs. The chorea that results from taking compounds containing oestrogen and progestogen has many features in common with chorea gravidarum, and the pathogenesis is probably similar. In some of the patients, however, the sudden onset of symptoms suggests a vascular aetiology.