Children With PANS May Manifest POTS.

Area of Science:

• Neurology
• Pediatrics
• Cardiology

Background:

• Pediatric acute-onset neuropsychiatric syndrome (PANS) is a condition characterized by abrupt psychiatric symptoms, often considered a post-infectious inflammatory brain disorder.
• Postural orthostatic tachycardia syndrome (POTS) involves an abnormal increase in heart rate upon standing, leading to various symptoms like fatigue and cognitive issues.

Purpose of the Study:

• To present a case of POTS in a PANS patient that resolved with immunomodulation.
• To determine the prevalence of POTS in a cohort of PANS patients.
• To compare clinical characteristics between PANS patients with and without POTS.

Main Methods:

• A cohort study including 204 patients meeting PANS criteria.
• Data collected through prospectively gathered questionnaires and medical record review.
• Statistical comparisons and Kaplan-Meier analysis were performed.

Main Results:

• 9% of PANS patients (19/204) showed evidence of POTS, with 5/19 having persistent POTS.
• POTS patients in the cohort were more likely to have joint hypermobility and chronic fatigue.
• PANS flares were significantly associated with POTS symptom exacerbation (OR 3.3).

Conclusions:

• The study found a high prevalence of POTS in PANS patients, exceeding general population rates.
• An association between POTS and PANS flares was supported within the studied cohort.
• These findings suggest a potential link between PANS and POTS, warranting further investigation.