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May 2021

Metabolomic Characterization of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

F Murgia, A Gagliana, MG Tanca, N Or-Geva, A Hendren, S Carucci, M Pintor, F Cera, F Cossu, S Sotgiu, L Atzori, A Zuddas. Metabolomic Characterization of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Frontiers in Neuroscience. Vol 15. 2021. DOI: 10.3389/fnins.2021.645267  

  • Found unique plasma metabolic profile in PANS patients that is significantly different from healthy children
  • Suggests involvement of specific patterns of neurotransmission (tryptophan, glycine, histamine/histidine)
  • Suggests a general state of neuroinflammation and oxidative stress (glutamine, 2-Hydroxybutyrate, and tryptophan-kynurenine pathway) in the disorder.
  • Offers new insights into biological mechanisms underpinning the disorder and supports research of other potential biomarkers implicated in PANS.
Sydenham Chorea Managed With Immunoglobulin in Acute Rheumatic Fever

Ali A, Anugwom G O, Rehman U, et al. (May 12, 2021) Sydenham Chorea Managed With Immunoglobulin in Acute Rheumatic Fever. Cureus 13(5): e14990. doi:10.7759/cureus.14990

Conclusions:  SC is a rare presentation of ARF. Without adequate treatment and supportive care, SC can cause severe functional impairment. ARF should be considered as a differential diagnosis in school-aged children presenting with choreiform movements. Chorea can be managed with antiepileptics and antipsychotics; however, evidence on IVIG use for chorea has also been reported. There is no international consensus on the standard choice of treatment; therefore, IVIG should be used in severe functional impairment when unresponsive to other therapies.

Paediatric Acute onset Neuropsychiatric Syndrome: Exploratory study finds no evidence of HLA class II association but high rate of autoimmunity in first‐degree relatives

Elisabeth Fernell, Mikael Sundin, Anders Fasth, Lisa Dinkler, Martyna Galazka, Christopher Gillberg, Mats Johnson Acta Paediatr. DOI: 10.1111/apa.15805

Conclusion
No HLA allele association such as seen in children with narcolepsy after H1N1 immunisation could be confirmed in this group of children with PANS. However, more than half the group had a first‐degree relative with a diagnosed autoimmune disease.

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