Ro 52 VASCULITIS WITH RECURRENT CHOREA

Dr. Moses P. Moorthy, Prof. Sanjeev V. Thomas, Prof. A. V. Srinivasan

Abstract


23 year old female presented with involuntary movement of right
upper and lower limb of 2 years duration. Apparently normal since 2
years back developed sudden onset of involuntary movements and
weakness of right upper and lower limbs. On examination patient had
choreiform movements of right upper limb and lower limb, right hemi
paresis with power 4/5 .On neuroimaging, MRI brain showed
decreased perfusion in caudate, lentiform nucleus and anterior limb of
internal capsule with multiple ischemic areas in the cerebral
parenchyma; suggestive of CNS vasculitis. On rheumatological
evaluation, positive for anti-nuclear antibody (ANA). ANA profile
was positive for Anti- Ro- 52 antibodies. Patient was on maintenance
immunotherapy with oral steroids and immunosuppressant. Patient
had 3 episodes of involuntary movements of right upper and lower
limbs in the past 2 years. This episode of involuntary movements lasted
for 10 days, since she discontinued the maintenance immunotherapy.
The involuntary movements subsided one week after restarting the
immunotherapy. These involuntary movements are choreiform in
nature.


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