Recurrent Chorea in Two Patients with Systemic Lupus Erythematosus and Secondary Antiphospholipid Syndrome / 대한류마티스학회지

ABSTRACT

Chorea is an uncommon movement disorder of systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APLS). It frequently develops early in the course of SLE and is not recurrent in most patients. In this report, we presented the clinical features of two cases of recurrent chorea secondary to APLS associated with SLE. A 24 year-old woman with SLE for 10 years was admitted because of choreic movement involved both extremities, facial and neck muscles. She had the same episode 1.5 years ago. Laboratory investigation showed increment in SLE activity, prolongation of aPTT without correction by mixing with normal plasma, and positive lupus anticoagulant. Brain MRI and SPECT revealed no evidence of ischemic change. The second case, a 36-year-old lady with SLE for 8 years, was admitted due to recurrent dysarthria. On physical examination, she had choreic movement involved neck and tongue. The activity of her disease increased and lupus anticoagulant was positive. Brain MRI showed infarct in insular cortex and multiple high signals in the frontal and occipital lobes. In both cases, haloperidol rapidly brought their symptom under control. We describe the first cases of secondary APLS-related recurrent movement disorder in Korea and review the literatures.