Intravenous immunoglobulin for the treatment of autoimmune encephalopathy in children with autism

Kathleen Connery, Marie Tippett, Leanna M. Delhey, Shannon Rose, John C. Slattery, Stephen G. Kahler, Juergen Hahn, Uwe Kruger, Madeleine W. Cunningham, Craig Shimasaki, Richard E. Frye
Transl Psychiatry-2018

In an open-labeled IVIG study in children with comorbid ASD and PANS/ PANDAS, anti-tubulin and anti-D2R (as measured by the Cunningham panel) were associated with responsiveness to IVIG treatment, suggesting that these autoantibodies could be biomarkers to select for positive IVIG treatment outcomes. Research continues to explore serum biomarkers and genetic risk factors that can provide a diagnostic tool and/or complement diagnosis in children with PANS/PANDAS.

Borrelia burgdorferi adhere to blood vessels in the dura mater and are associated with increased meningeal T cells during murine disseminated borreliosis

li Divan, Timothy Casselli, S. Anand Narayanan, Sanjib Mukherjee, David C. Zawieja, John A. Watt, Catherine A. Brissette, M. Karen Newell-Rogers, Published: May 3, 2018. https://doi.org/10.1371/journal.pone.0196893

Traditionally, mice haven’t shown neuroborreliosis, mirroring human symptoms, but this study achieved colonization of the central nervous system in mice. Using two strains of B. burgdorferi, researchers infected mice through the skin, consistently detecting spirochetes in the brain membranes 75 days post-infection. Live spirochetes were present, adhering to blood vessels, indicating long-term infection. The presence of CD3+ T cells suggested an immune response. These findings provide new avenues for studying neuroborreliosis and may offer insights into potential treatments for patients.

PANDAS and anorexia nervosa-a spotters’ guide: Suggestions for medical assessment
Vincenzi B, O’Toole J, Lask B. PANDAS and anorexia nervosa–a spotters’ guide: suggestions for medical assessment. Eur Eat Disord Rev. 2010 Mar;18(2):116-23. doi: 10.1002/erv.977. PMID: 20148396.
Conclusion: Given the current state of knowledge, diagnosingPANDAS is extraordinarily difficult. However, extrapolating from knowledge aboutSydenham’s choreaandPANDAS–OCD and PANDAS–tics/TS, a heightened index of suspicion for the existence of an auto-immune reaction in the brain response to environmental infectious agents culminating in ‘anorexia nervosa’ should be maintained.