100 Antiphospholipid-related chorea

Chorea of subacute onset is a movement disorder that typically has monophasic course. can be associated with autoimmune diseases such as antiphospholipid syndrome and been the isolated presence antibodies (aPL). Here, we report patient aPL-related chorea unusually followed relapsing-remitting A female in her forties developed gravidarum during first pregnancy, eight years previously, again second pregnancy five ago. Investigations showed high titre triple positivity aPL. No basal ganglia lesion or signal change was identified on MRI brain. There no history arterial venous thromboembolism morbidity. Her symptoms continued post-partum she received treatment low-molecular-weight-heparin, prednisolone intravenous immunoglobulin, while breastfeeding. Tetrabenazine trialled, which helped to suppress chorea, though lowered mood. The remitted. She recurrence three later, when not pregnant taking hormone therapy. had significant irritability. Olanzapine trialled benefit movements mood improved. relapsed fourth two later recommenced olanzapine, symptomatic benefit. currently trialling pulsed oral methylprednisolone by azathioprine.