AUTHOR=Murciano Manuel , Biancone Davide Maria , Capata Giulia , Tristano Isabella , Martucci Vanessa , Guido Cristiana Alessia , Anaclerio Silvia , Loffredo Lorenzo , Zicari Anna Maria , Duse Marzia , Spalice Alberto 

TITLE=Focus on Cardiologic Findings in 30 Children With PANS/PANDAS: An Italian Single-Center Observational Study

JOURNAL=Frontiers in Pediatrics

VOLUME=7

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00395

DOI=10.3389/fped.2019.00395

ISSN=2296-2360

ABSTRACT=<p><bold>Objective:</bold> Cardiac involvement in PANS has not been clarified relying on the scientific literature available until today. It is known that streptococcal infections play a role in the etiology of a great number of diseases including Sydenham chorea and rheumatic fever, among others. Based on the suspected pathogenesis of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) reported in the medical literature, we decided to investigate the cardiologic involvement in children with a recent PANS/PANDAS diagnosis.</p><p><bold>Methods:</bold> The study population satisfies PANS (<xref ref-type="bibr" rid="B1">1</xref>) and PANDAS (<xref ref-type="bibr" rid="B2">2</xref>) criteria of diagnoses. Cardiologic assessment was performed through clinical examination, electrocardiography, and echocardiography.</p><p><bold>Results:</bold> In the selected pediatric population, a significant number of children presented mitral valve involvement, systolic murmurs and electrocardiographic abnormalities. High ASLOT levels did not seem to be associated to a cardiac involvement.</p><p><bold>Conclusions:</bold> Often PANS is difficult to diagnose because it is little known by physicians and most of the cardiologic findings described in this study are common among the healthy pediatric population. Also, ASLOT levels seems not to be predictive of cardiac involvement. Furthermore, the existence of PANDAS as a clinical entity is associated with a group of anti-neuronal autoantibodies found in Sydenham chorea is still controversial. We recommend a complete cardiologic evaluation in those children who meet the PANS/PANDAS diagnostic criteria.</p>