Monthly Archives:
August 2022

Hajjari, P., Oldmark, M.H., Fernell, E. et al. Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) and intravenous immunoglobulin (IVIG): comprehensive open-label trial in ten children. BMC Psychiatry 22, 535 (2022). https://doi.org/10.1186/s12888-022-04181-x

Conclusion: Considerable and pervasive improvements in symptoms and clinical impairments were seen in these ten children after three monthly IVIG treatments. Moderate to severe transient side effects occurred in three cases.

• Considerable improvements of PANS global symptoms and impairment were seen on the PANS Scale, CGI-S, CGI-I, and improved OCD symptoms on the CY-BOCS scale, lasting at least one month after the third IVIG treatment (at Visit 3).
• All children had improved at Visit 1 (one month after the first IVIG treatment).
• At Visit 3 – 8 of 10 children had lasting improvements, but 2 showed symptom rebounds
  • 1 patient had good but transient responses lasting only 2–3 weeks after each IVIG, followed by deteriorations
  • One had a concurrent viral infection at Visit 3.
• At baseline the severe symptoms had considerable impact on the children’s school attendance
  • Marked improvements in attendance were seen post-treatment
  • School absence during 3 months before baseline was 47% of the school days/month, compared to 13% after the third IVIG treatment.
• The main side effects were of a previously well-known type, i.e. transient headache, neck pain, nausea/vomiting (mild to severe), stomach pain, mild transient anemia, and brief allergic reaction.

Hutanu A, Reddy L N, Mathew J, et al. (August 06, 2022) Pediatric Autoimmune Neuropsychiatric Disorders Associated With Group A Streptococci: Etiopathology and Diagnostic Challenges. Cureus 14(8): e27729. doi:10.7759/cureus.27729

O’Dor, S.L., Zagaroli, J., Belisle, R. et al. The COVID-19 pandemic and children with PANS/PANDAS: an evaluation of symptom severity, telehealth, and vaccination hesitancy. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01401-z

• Assessed the impact of the COVID-19 pandemic on children with PANS/PANDAS
• A majority of respondents endorsed a negative impact on their child’s friendships, relationships with extended family, hobbies, and academic skills due to the pandemic
• Children with suspected or diagnosed COVID-19 experienced new or worsened psychiatric symptoms, particularly mood lability, OCD, and anxiety
• Telehealth care was the preferred treatment modality if the child had mild symptoms of PANS/PANDAS
• Caregivers experienced a high level of burn-out both before and during the pandemic, and thus this should continue to be an area of inquiry and appropriate intervention by providers
• Data suggest an overall negative impact of the COVID-19 pandemic on children with PANS/PANDAS and their caregivers.

Konstantinou GN, Konstantinou GN, Koulias C, Petalas K, Makris M. Further Understanding of Neuro-Immune Interactions in Allergy: Implications in Pathophysiology and Role in Disease Progression. J Asthma Allergy. 2022;15:1273-1291. https://doi.org/10.2147/JAA.S282039

“We have systematically reviewed and discussed the evidence regarding the role of the neuro-immune interactions in common allergic clinical modalities like allergic rhinitis, chronic rhinosinusitis, allergic asthma, food allergy, atopic dermatitis, and urticaria. It is essential to understand unknown – to most of the immunology and allergy experts – neurological networks that not only physiologically cooperate with the immune system to regulate homeostasis but also pathogenetically interact with more or less known immunological pathways, contribute to what is known as neuroimmunological inflammation, and shift homeostasis to instability and disease clinical expression.”