Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) and intravenous immunoglobulin (IVIG): comprehensive open-label trial in ten children

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.