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Colour Doppler echocardiography in children with group A streptococcal infection related tic disorders
F Cardona1, A Romano, G Cundari
1Departments of Child Neuropsychiatry, University La Sapienza of Rome, Italy.
Insights
This study investigated children with tic disorders and streptococcal infections, finding some had mitral valve abnormalities. These findings suggest a potential link between Group A Streptococcus infections and the pathophysiology of certain tic disorders.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Cardiology
Background:
- A potential link between tic disorders and streptococcal infections has been proposed.
- Understanding the complex relationship between streptococcal infections and childhood neuropsychiatric disorders is crucial.
Purpose of the Study:
- To investigate the relationship between streptococcal infections and neuropsychiatric disorders in children.
- To examine children with possible post-streptococcal tic disorders using color Doppler echocardiography.
Main Methods:
- The study included 23 children with tic disorders and a history of streptococcal infections.
- Echocardiographic examinations and laboratory tests were performed.
- Patients were monitored for up to 1 year.
Main Results:
- Mild or minimal mitral insufficiency was observed in 12 patients, all hemodynamically insignificant.
- 10 of these patients had high anti-streptolysin O (ASO) titers, and 5 had positive Group A Streptococcus (GAS) cultures.
- Abnormal erythrocyte sedimentation rate (ESR) was noted in 9 patients.
Conclusions:
- The study suggests that the pathophysiology of Group A Streptococcus (GAS)-related tic disorders may be similar to Sydenham's chorea in some cases.
- Further research is needed due to the study's design and small sample size.
Background & Objectives:
A possible relationship has been suggested between tic disorders and streptococcal infections. To understand the complex relationship between streptococcal infections and neuropsychiatric disorders in children the present study was done on colour Doppler echocardiography of patients with possible post-streptococcal tic disorders.
Methods:
The patients were 23 children (22 males, 1 female) affected by tic disorders, who at the time of the observation presented (or had presented in the past) signs of streptococcal infections temporally related to the onset or recrudescence of tic disorders. Echocardiographic examination and laboratory tests were performed on these children.
Results:
In 4 cases a mild mitral insufficiency and in 8 cases a minimal mitral insufficiency was seen, all haemodynamically not significant. Follow up studies (up to 1 yr) showed the consistency and persistence of these findings. Of the 12 patients with echocardiographic abnormalities, 10 displayed very high anti streptolysin O (ASO) titres, 5 showed positive cultures for GAS and 9 had abnormal ESR, even if no significant differences were found in respect to patients with tics and normal echocardiography.
Interpretation & Conclusion:
With the caution due to the design of study and to low number of patients, our data seem to indicate that the pathophysiology of GAS-infection related tic disorders is similar to that SC, at least in some cases.
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