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The Wall Was Hard to See
The Wall Was Hard to See

This story exemplifies how it is sometimes hard to see the sudden onset or sudden worsening of PANS PANDAS symptoms as you are living (struggling) through it. Remember, someone with PANS PANDAS does...

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The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
Nykytyuk S, Boyarchuk O, Klymnyuk S, Levenets S. The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis. Reumatologia. 2020;58(5):335-338. doi: 10.5114/reum.2020.99143. Epub 2020 Oct 3. PMID: 33227092; PMCID: PMC7667941.
  • A 13-year-old boy developed Lyme arthritis and experienced a severe Jarisch-Herxheimer reaction on day 7 of doxycycline treatment.
  • Symptoms included low-grade fever, severe joint and muscle pain, and increased inflammatory markers.
  • Unlike the typical mild, short-lived reaction seen in adults, this case was prolonged and intense.
  • Raising awareness among healthcare professionals can help differentiate this reaction from allergies or other conditions, improving patient care.
Psychosocial Interventions and Immune System Function – A Systematic Review and Meta-analysis of Randomized Clinical Trials
Shields GS, Spahr CM, Slavich GM. Psychosocial Interventions and Immune System Function: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Psychiatry. 2020 Oct 1;77(10):1031-1043. doi: 10.1001/jamapsychiatry.2020.0431. PMID: 32492090; PMCID: PMC7272116.
  • Inflammation-linked diseases cause over 50% of global deaths. Psychosocial interventions may help, but it’s unclear which work best and for whom.
  • Study: Systematic review and meta-analysis of 56 RCTs (4,060 participants) across 8 psychosocial interventions and 7 immune markers.
  • Findings: Interventions led to a 14.7% improvement in beneficial immune function and 18% reduction in harmful immune activity.
  • Most effective: CBT and combined/multiple interventions, especially those targeting proinflammatory markers.
  • Lasting effects: Benefits persisted at least 6 months post-treatment and held across age, sex, and treatment duration.
  • Conclusion: Psychosocial interventions reliably improve immune function and may be a useful public health strategy.
Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome

Chan, A., Karpel, H., Spartz, E. et al. Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome. Pediatr Res 89, 1477–1484 (2021). https://doi.org/10.1038/s41390-020-1103-3

Conclusion: Hypoferritinemia and iron deficiency appear to be more common in PANS patients. More research is needed to confirm and understand this association.

  • 79 subjects (mean age of PANS onset of 8.7 years)
  • Hypoferritinemia was observed in 27% and three quarters occurred during a PANS flare
  • PANS patients with hypoferritinemia had worse global impairment, more comorbid inflammatory diseases, and exhibited a chronic course of PANS illness than those without
  • The estimated prevalence of iron deficiency was 3–8% in the PANS cohort, 1.4–2.0-fold higher than in the age- and sex-matched U.S. population.
  • Hypoferritinemia was commonly observed during a disease flare but not associated with dietary or demographic factors.
  • In patients with PANS and iron deficiency, clinicians should consider possibility of inflammation as the cause especially if iron deficiency cannot be explained by diet and blood loss.