SLE presenting as migratory arthritis, chorea and nephritis

We present a case of a 12-year-old girl who presented with migratory arthritis, chorea and ascites. She was diagnosed to have systemic lupus erythematosus (SLE) and subsequently responded to immunosuppressive therapy. She had been misdiagnosed earlier as having rheumatic fever. Our case highlights the fact that SLE should be considered in the differential diagnosis of a patient with migratory arthritis & chorea. Generally, chorea in SLE is immune-mediated rather than due to ischemia and has good prognosis.

[1]  J. Jankovic,et al.  Movement disorders in systemic lupus erythematosus and the antiphospholipid syndrome , 2013, Journal of Neural Transmission.

[2]  Jamal A Albishri.  Chorea as a First Manifestation in Young Patients with Systemic Lupus Erythematosus Who Was Initially Diagnosed With Rheumatic Fever , 2012, Clinical medicine insights. Case reports.

[3]  M. Vidailhet,et al.  Long‐term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies , 2011, Movement disorders : official journal of the Movement Disorder Society.

[4]  J. Baizabal-Carvallo,et al.  Chorea in Systemic Lupus Erythematosus , 2011, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.

[5]  M. Edwards,et al.  Atypical movement disorders in antiphospholipid syndrome , 2006, Movement disorders : official journal of the Movement Disorder Society.

[6]  J. Chapman,et al.  Antiphospholipid antibodies permeabilize and depolarize brain synaptoneurosomes , 1999, Lupus.

[7]  R. de la Fuente-Fernández.  Lupus anticoagulant and chorea , 1997, Neurology.

[8]  Á. Chamorro,et al.  Chorea in the Antiphospholipid Syndrome: Clinical, Radiologic, and Immunologic Characteristics of 50 Patients from Our Clinics and the Recent Literature , 1997, Medicine.

[9]  T. Ishikawa,et al.  Alternating hemichorea in primary antiphospholipid syndrome , 1994, Neurology.

[10]  A. Steinberg,et al.  Long-term preservation of renal function in patients with lupus nephritis receiving treatment that includes cyclophosphamide versus those treated with prednisone only. , 1991, Arthritis and rheumatism.