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Children With PANS May Manifest POTS, 2022, Chan et al

Discussion in 'Other health news and research' started by Andy, May 14, 2022.

  1. Andy

    Andy Committee Member

    Hampshire, UK
    Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by an abrupt-onset of severe psychiatric symptoms including OCD, anxiety, cognitive difficulties, and sleep issues which is thought to be a post-infection brain inflammatory disorder. We observed postural orthostatic tachycardia syndrome (POTS) which resolved with immunomodulation in a patient with Pediatric acute-onset neuropsychiatric syndrome (PANS). Here, we aim to present a case of POTS and to examine the prevalence of (POTS) in our PANS cohort, and compare the clinical characteristics of patients with and without POTS.

    Study Design: We conducted this cohort study of patients meeting PANS criteria who had at least three clinic visits during the study period. We included data from prospectively collected questionnaires and medical record review. We present a case followed by statistical comparisons within our cohort and a Kaplan-Meier analysis to determine the time-dependent risk of a POTS diagnosis.

    Results: Our study included 204 patients: mean age of PANS onset was 8.6 years, male sex (60%), non-Hispanic White (78%). Evidence of POTS was observed in 19/204 patients (9%) with 5/19 having persistent POTS defined as persistent abnormal orthostatic vitals, persistent POTS symptoms, and/or continued need for pharmacotherapy for POTS symptoms for at least 6 months). In this PANS cohort, patients with POTS were more likely to have comorbid joint hypermobility (63 vs 37%, p = 0.04), chronic fatigue (42 vs 18%, p = 0.03), and a family history of chronic fatigue, POTS, palpitations and syncope. An unadjusted logistic regression model showed that a PANS flare (abrupt neuropsychiatric deterioration) was significantly associated with an exacerbation of POTS symptoms (OR 3.3, 95% CI 1.4–7.6, p < 0.01).

    Conclusions: Our study describes a high prevalence of POTS in patients with PANS (compared to the general population) and supports an association between POTS presentation and PANS flare within our cohort.

    Open access, https://www.frontiersin.org/articles/10.3389/fneur.2022.819636/full
    Hutan, mango, Samuel and 3 others like this.
  2. rvallee

    rvallee Senior Member (Voting Rights)

    Not entirely convinced of the full validity of a full resolution:
    This doesn't sound that coincidental:
    Anyway I was looking for what treatment they used and: IVIG.
    alktipping and Peter Trewhitt like this.
  3. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

  4. Samuel

    Samuel Senior Member (Voting Rights)

    i think it is entirely natural that if you have pans, you might also have pots. and spatulas.

    lipkin and hornig and others did at least one paper on pandas [perhaps this: https://pubmed.ncbi.nlm.nih.gov/19668249/]. and i think hornig might have suggested at one point m.e. etiology could be similar.

    in that paper something like: they injected mice with strep; the mice displayed ocd-like behaviors. injecting with strep antibodies caused issues with memory, social interactions, and more.

    then removing the antibodies seemed to cause normal behavior. idk the status of the science, but i've read that humans with pandas do similar with staph infections. and that they display m.e.-like vigilance [wired but tired?]. [and add and anxiety.]

    this area in general feels like it could in principle bring together neglected diseases possibly including m.e. and dysauto.

    i'd like more treatments than ivig for scientists to try. scarce and not always tolerated.
    Last edited: May 16, 2022
    Hutan, Trish and Peter Trewhitt like this.

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