The known and unknown of post-pump chorea: a case report on robust steroid responsiveness implicating occult neuroinflammation

Front Immunol. 2024 Sep 10:15:1458022. doi: 10.3389/fimmu.2024.1458022. eCollection 2024.

Abstract

Post-pump chorea (PPC) is characterized by the development of choreiform movements following cardiopulmonary bypass (CPB) surgery. PPC occurs almost exclusively in children, and its pathophysiology remains unclear. Here we present an adult case of PPC after bovine aortic valve replacement (AVR) which exhibited dramatic and reproducible response to steroid, suggesting the presence of occult neuroinflammation. This observation suggests a novel underlying mechanism in certain subgroups of PPC, which is likely a heterogeneous condition to start with. Further research into the pathomechanisms of PPC could offer insights into managing this otherwise symptomatic control-only condition.

Keywords: bioprosthetic aortic valve; cardiopulmonary bypass (CPB); chorea (non-Huntington’s); hypoxia inducible factor; neuroinflammation; post-pump chorea.

Publication types

  • Case Reports

MeSH terms

  • Aortic Valve / pathology
  • Aortic Valve / surgery
  • Cardiopulmonary Bypass* / adverse effects
  • Chorea* / drug therapy
  • Chorea* / etiology
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Neuroinflammatory Diseases* / etiology
  • Neuroinflammatory Diseases* / immunology
  • Postoperative Complications / etiology

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.