Monthly Archives:
February 2022

Profiling Behavioral and Psychological Symptoms in Children undergoing treatment for Spondyloarthritis and Polyarthritis

McHugh A, Chan A, Herrera C, Park JM, Balboni I, Gerstbacher D, Hsu JJ, Lee T, Thienemann M, Frankovich J. Profiling Behavioral and Psychological Symptoms in Children undergoing treatment for Spondyloarthritis and Polyarthritis. J Rheumatol. 2022 Feb 1:jrheum.210489. doi: 10.3899/jrheum.210489. Epub ahead of print. PMID: 35105715.

Results: There were 111 patients and 1753 healthy controls (HCs). Compared to HCs, patients with SpA or PolyA had worse total competence and internalizing scores. Higher cJADAS10 scores were associated with worse total competence, worse internalizing, and higher total problems scores. Most of these differences reached statistical significance (P < 0.01). Self-harm/suicidality was almost 4-fold higher in patients with PolyA than HCs (OR 3.6, 95% CI 1.3-9.6, P = 0.011).

Conclusion: Our study shows that patients with SpA and PolyA with more active disease have worse psychological functioning in activities, school, and social arenas, and more internalized emotional disturbances, suggesting the need for regular mental health screening by rheumatologists.

Status Of Vitamin D In Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)
McNally JD, Menon K, Chakraborty P, Fisher L, Williams KA, Al-Dirbashi OY, Doherty DR; Canadian Critical Care Trials Group. The association of vitamin D status with pediatric critical illness. Pediatrics. 2012 Sep;130(3):429-36. doi: 10.1542/peds.2011-3059. Epub 2012 Aug 6. PMID: 22869837.
“Numerous studies have indicated an association between vitamin D deficiency and the immune dysregulation and the pathogenesis of autoimmunity. An increased prevalence of vitamin D deficiency has been demonstrated in several pediatric autoimmune diseases, including autoimmune thyroid disease and Type-1 diabetes mellitus. This study was undertaken to determine the prevalence of vitamin D deficiency in children with PANS, an autoimmune disorder characterized by abrupt-onset neuropsychiatric symptoms.”
Neuropsychiatric syndrome with myoclonus after SARS-CoV-2 infection in a paediatric patient

M. Della Corte, C. Delehaye, E. Savastano, M.F. De Leva, P. Bernardo, A. Varone, Neuropsychiatric syndrome with myoclonus after SARS-CoV-2 infection in a paediatric patient, Clinical Neurology and Neurosurgery, Volume 213, 2022. DOI: 10.1016/j.clineuro.2022.107121

  • 12 Year old subacutely developed a positive and negative myoclonus of limbs and face, drowsiness and memory deficits after getting infected by SARS-CoV-2.
  • Neuropsychological examination showed an impairment in memory, visual-motor coordination, inductive reasoning skills, attention, and concentration
  • First treated with clonazepam and then with intravenous methylprednisolone for five days, with poor response.
    • Then received a cycle of IVIG, thus reaching a gradual and complete recovery.
  • To date, this is the first case of a COVID-19 associated myoclonus affecting a paediatric patient.
Antistreptolysin-O Titers: Implications for Adult PANDAS

Letter to the Edito. Antistreptolysin-O Titers: Implications for Adult PANDAS. ANDREW J. CHURCH, B.SC., and RUSSELL C. DALE, M.B.CH.B., M.R.C.P., London, U.K. Published Online:1 Feb 2002. https://doi.org/10.1176/appi.ajp.159.2.320

To the Editor: A diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is made when neuropsychiatric disease is precipitated by streptococcal infection (1). Antistreptolysin-O titers are an important tool for diagnosing recent streptococcal infection in patients with Sydenham’s chorea and PANDAS, since throat cultures are usually negative because of the latent onset of the neuropsychiatric disease. The upper limit for normal antistreptolysin-O titers is 200 IU/ml in children, but no normal upper limit exists for healthy adults. We propose that an antistreptolysin-O titer of 270 IU/ml is the significant upper limit for healthy adults. This finding will aid in the investigation and diagnosis of new cases of adult PANDAS.