A 38-year-old woman with childhood rheumatic fever presents with involuntary jerky movements of her face and limbs following a recent streptococcal pharyngitis. Vital signs: BP 118/76, HR 92, RR 18, Temp 37.2°C, SpO2 98% on room air. She displays emotional lability and hypotonia. Notably, she has no fever currently. ESR is elevated at 42 mm/hr. Which of the following best explains the pathophysiologic mechanism underlying this movement disorder?

1. A)CAG repeat expansion in chromosome 4
2. B)Copper deposition in the putamen
3. C)Subthalamic infarction from chronic hypertension
4. D)Loss of substantia nigra neurons due to alpha-synuclein aggregation
5. E)Autoimmune injury to basal ganglia structures causing choreaGABARITO