Thomas T, Eyre M, Ferrarin E, Newlove-Delgado T, Sie A, Armangue T, Ben-Pazi H, Benrhouma H, Clavenna A, Cardoso F, Dure LS, Jones HF, Gilbert DL, Gulati S, Jiang Y, Krajnc N, Mohammad SS, Orsini A, Sharma S, Swedo SE, Webb R, Wilmshurst JM, Yaramis A, Yilmaz S, Zuberi SM, Morton M, Dale RC, Nosadini M, Lim M. Evaluation, diagnosis, and treatment of Sydenham chorea: consensus guidelines. Pediatrics. 2025;156(6):e2025072466. doi:10.1542/peds.2025-072466
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Developed through a Delphi consensus process involving 27 international experts across neurology, psychiatry, and patient representation. Generated 88 consensus recommendations for evaluation, diagnosis, and management of children with Sydenham chorea.
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Emphasizes identification of core clinical features, including chorea and hypotonia, and screening for neuropsychiatric, cognitive, speech, swallowing, and mobility impairments.
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Recommends assessment for acute rheumatic fever features, including carditis, with etiologic evaluation tailored to regional risk.
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Supports antibiotic treatment at first presentation and long-term secondary prophylaxis per guidelines.
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Recommends corticosteroids for moderate to severe disease and IVIG or plasma exchange for inadequate recovery.
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Stresses the importance of patient, family, and school support to reduce academic and social impact.
Gabriella True
