Rose Jeppesen, Michael Eriksen Benros
Frontiers in Psychiatry
The increasing knowledge on the potential involvement of inflammatory processes in mental disorders and the associations found between autoimmunity and psychotic disorders can help the expanding field of immuno-psychiatry and have impact on the outcome of patients. In the last couple of years, researchers have focused on the role of infections, autoantibodies and other immune components that plays a major role in autoimmune diseases. Potentially this might also be the case for mental disorders.
Methods: Evaluation of a 14-year-old boy with sudden-onset psychotic behavior. Bartonella spp. serology, PCR, DNA sequencing, and blood culture used for assessment. PCR assays for other vector-borne infections performed.
Results:
Conclusions: B. henselae bloodstream infection may contribute to persistent neuropsychiatric symptoms in a subset of PANS patients.
Elizabeth Heavey; Kathleen Peterson
The Nurse Practitioner-2019
Pediatric acute-onset neuropsychiatric syndrome (PANS) can be caused by infectious and noninfectious triggers. NPs can help children with PANS recover from their symptoms and prevent future recurrences by appropriately screening, recognizing, and diagnosing the clinical presentation of PANS. PANS treatment includes pharmacologic therapies as well as cognitive behavioral therapy.
Johnson, Fernell, Preda, Wallin, Fasth, Gillberg, Gillberg.
Lancet Child Adolesc Health-2019
Excerpt: Of 41 patients (37 referred and four visited upon parents’ request), 23 (ten girls and 13 boys) met PANS diagnostic criteria. Mean age at PANS onset was 8·5 years (SD 3·37). 11 (48%) patients had a family history of developmental or neuropsychiatric disorders in a first-degree relative and 11 (48%) had a family history of autoimmune or inflammatory diseases in a first-degree relative.
Silverman M, Frankovich J, Nguyen E, Leibold C, Yoon J, Mark Freeman G Jr, Karpel H, Thienemann M.
J Psychiatr Res.-2019
Conclusions: Over 1/3 of children with PANS experienced transient hallucinations. They were more impaired than those without psychotic symptoms, but showed no differences in disease progression. This difference may point toward heterogeneity in PANS. When evaluating children with acute psychotic symptoms, clinicians should screen for abrupt-onset of a symptom cluster including OCD and/or food refusal, with neuropsychiatric symptoms (enuresis, handwriting changes, tics, hyperactivity, sleep disorder) before initiating treatment.
Santiago Mora, Elena Martín-González, Pilar Flores, Margarita Moreno
Brain, Behavior, and Immunity-2019
Preclinical Animal Models are advancing our knowledge of Post-Infectious BGE
Abstract: Epidemiological studies, animal models, and case–control studies indicate maternal immune activation may be an important factor involved in disease expression of autism spectrum disorder (ASD), Tourette syndrome, and obsessive–compulsive disorder (OCD). We report eight children (mean age 6y 6mo [range 4–15y]; six males and two females) referred over a 2‐year period with at least one of these neurodevelopmental disorders plus a maternal history of thyroid autoimmunity…
Gamucci A, Uccella S, Sciarretta L, D’Apruzzo M, Calevo MG, Mancardi MM, Veneselli E, De Grandis E.
J Child Adolesc Psychopharmacology-2019
Conclusions: Despite these limitations, this study presents clinical, biological, and psychological features of a group of patients fulfilling the PANS and PANDAS criteria and discusses these results in comparison with patients with SC, a well-established clinical condition. Moreover, it adds notable findings to the existing little literature on neuropsychological functioning in youth diagnosed with these disorders, in particular PANS and PANDAS…
Leibold C, Thienemann M, Farhadian B, Willett T, Frankovich J.
J Child Adolesc Psychopharmacololgy-2019
Results: The GIS shows excellent discriminant validity, distinguishing patients with PANS from healthy controls. The scores on the GIS show an acceptable level of agreement with the clinician-reported CGAS. The regression line in the Bland–Altman plot had a positive slope, indicating that parents tend to report higher disease severity than clinicians at higher levels of disease severity. Correlation was higher during disease remissions than during disease flares (r = −0.69 vs. r = −0.48). All disease severity scales predicted GIS in the expected direction