Children With PANS May Manifest POTS

SUMMARY

“Children With PANS May Manifest POTS” discusses a notable overlap between two conditions that may share underlying autoimmune or inflammatory mechanisms: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Postural Orthostatic Tachycardia Syndrome (POTS).

Researchers at the Stanford Immune Behavioral (IBH) PANS Clinic conducted a retrospective study involving 204 pediatric patients diagnosed with PANS at the clinic and discovered that 19% also met the criteria for POTS—a form of dysautonomia marked by excessive heart rate increase upon standing, along with symptoms such as dizziness, fatigue, palpitations, and lightheadedness. In this sample, the prevalence of POTS (9%) was higher than in the general population (1%). PANS patients with POTS had higher BMI at initial clinic presentation, and their psychometric test scores revealed higher psychiatric symptom impairment. Patients with both diagnoses also had more comorbid joint hypermobility and chronic fatigue.

POTS was more likely observed during a PANS flare. The study found that addressing POTS symptoms led to significant improvements not only in physical symptoms but also in the neuropsychiatric symptoms associated with PANS. This dual improvement suggests that autonomic dysfunction may exacerbate or even drive some neuropsychiatric manifestations in affected children. The authors stress the importance of interdisciplinary collaboration in managing these complex cases, advocating for routine screening of autonomic symptoms in children with PANS to enhance diagnostic accuracy and optimize treatment outcomes.

LINK TO PAPER: https://doi.org/10.3389/fneur.2022.819636