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Discovering prescription patterns in pediatric acute-onset neuropsychiatric syndrome patients
Lopez Pineda A, Pourshafeie A, Ioannidis A, Leibold CM, Chan AL, Bustamante CD, Frankovich J, Wojcik GL. Discovering prescription patterns in pediatric acute-onset neuropsychiatric syndrome patients. J Biomed Inform. 2021 Jan;113:103664. doi: 10.1016/j.jbi.2020.103664. Epub 2020 Dec 28. PMID: 33359113.
  • PANS has an inflammatory or autoimmune etiology associated with an infection.
  • Longitudinal clustering can subset patients with polypharmacy treatments.
  • Included 43 consecutive new-onset pre-pubertal patients who had at least 3 clinic visits. “We used a cut-off age of 12 years to include only pre-pubertal children, as hormones might play a role in psychiatric symptoms and behaviors.”
  • Algorithm identified six clusters with distinct medication usage history which may represent clinician’s practice of treating PANS of different severities and etiologies i.e.,
    • two most severe groups requiring high dose intravenous steroids
    • two arthritic or inflammatory groups requiring prolonged nonsteroidal anti-inflammatory drug (NSAID)
    • two mild relapsing/remitting group treated with a short course of NSAID.
  • The psychometric scores as outcomes in each cluster generally improved within the first two years.
    Diagnostics, Differential Diagnostics And The Treatment Of Pandas Syndrome – Case Description

    Diagnostics, Differential Diagnostics And The Treatment Of Pandas Syndrome – Case Description Mukhtorjonova Khusnigul Nodirbekovna, Tukhtabayeva Kamila Abrarovna, Tashkent Padiatric Medical Institute. World Bulletin of Public Health (WBPH). Volume-6, January 2022. ISSN: 2749-3644

    This article gives a case of PANDAS syndrome in an 11-year-old boy. The
    course and clinic of the disease in the form of prolonged sneezing attacks
    made it difficult to diagnose this syndrome. Conducting biochemical blood
    tests, daily video electroencephalographic monitoring (EEG monitoring) and
    magnetic resonance imaging of the brain (MRI) allowed to determine the
    condition. The appointment of antibiotic therapy and intravenous
    administration of immunoglobulin led to remission of the disease. It is
    necessary to conduct further studies to determine the effectiveness of the
    above drugs for this syndrome.

    Read case study.

    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.