PAEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDER ASSOCIATED WITH GROUP A STREPTOCOCCAL INFECTION (PANDAS): CARDIAC AND ARTICULAR INVOLVEMENT

Background: PANDAS is a syndrome characterized by obsessive-compulsive disorder (OCD) and/or tic disorder with symptom exacerbations in children after group A β-hemolytic streptococcal (GAS) infections. No cardiac nor articular involvement is present as in the case of Sydenham Chorea. Antinuclear antibodies and nuclear basal involvement at brain MR may be encountered. Objectives: We evaluated the possible misdiagnosed cardiac and articular involvement in 30 children affected by PANDAS and regularly assessed at an out-patient ambulatory in the period from 2007 to 2011. Methods: 30 children affected by PANDAS according the Swedo SA diagnostic criteria were evaluated at the out-patient ambulatory of the Rhematologic and Neuropsichiatric departments of Verona's University Hospital in the period from 2007 to 2011; thorough cardiologic evaluation encompassing ECG and echocardiogram was performed Results: mean age of the 30 young patients (M:F 23:7) was 7±3 years; all had sierologic evidence of previous streptococcal infection; ECG was normal in all the cases as well as cardiac echogram with the exception of 2 cases of trivial mitral regurgitation without structural valvular alterations; no patient was affected by perferic arthritis, arthargias nor morning stiffness. Conclusions: the absence of cardiac or articular involvement in PANDAS patients, as evidenced in this study, confirms its differential diagnosis with Sydenham Chorea