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IVIG

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.
DIAGNOSTICS, DIFFERENTIAL DIAGNOSTICS AND TREATMENT OF PANDAS SYNDROME: DESCRIPTION OF THE CASE

DIAGNOSTICS, DIFFERENTIAL DIAGNOSTICS AND TREATMENT OF PANDAS SYNDROME: DESCRIPTION OF THE CASE. Mukhtorjonova Khusnigul Nodirbekovna, Elmurodova Zarina Aslanovna. Matkarimova Dilnoza Doniyorovna, Tashkent Pediatric Medical Institute. ISSN: 2776-0960 Volume 2, Issue 6, June 2021

The analysis of this clinical case demonstrates the existence of a group of patients with a good therapeutic response to the administration of immunoglobulins and antibiotics. The mechanisms of development and course of this condition are not fully understood and require further research.

The interference of laboratory tests by immunoglobulin infusion: Problems and solutions

Chen, Renfen & Wei, Xiumei. (2021). The interference of laboratory tests by immunoglobulin infusion: Problems and solutions. Journal of Clinical Images and Medical Case Reports. 2. 10.52768/2766-7820/1047.

  • IVIG infusion can interfere with a wide range of laboratory tests, leading to inaccurate results.
  • The interference stems from the transfer of antibodies and biological agents from donors to patients during IVIG treatment.
  • This interference affects tests in infectious disease serology, autoimmune serology, blood bank, haematology, and biochemistry.
  • After receiving IVIG (intravenous immunoglobulin), testing for pathogens can be influenced by the antibodies present in the IVIG product. These antibodies may show decreased positivity over time, with the antibodies disappearing approximately 2-4 months after the IVIG treatment ceases. It’s crucial to consider the potential impact of IVIG on testing accuracy and consult with healthcare providers for guidance on the timing and methods of pathogen testing post-IVIG treatment.
Benefits of IVIG in Pediatric Acute-Onset Neuropsychiatric Syndrome

Benefits of IVIG in Pediatric Acute-Onset Neuropsychiatric Syndrome

Isaac Melamed, Roger Kobayashi, Maeve O’Connor, Ai Lan Kobayashi, Andrew Schechterman, Melinda Heffron, Sharon Canterberry, Holly Miranda, Nazia Rashid Neurology Apr 14 2020, 94

“Conclusions: In PANS, which may be associated with an underlying immune dysregulation, IVIG [Octagam 5%] successfully ameliorated psychological symptoms and dysfunction, with sustained benefits for at least 8 weeks, and up to 46 weeks, following the final infusion. In addition, baseline immune and autoimmune profiles demonstrated significant elevations in a majority of subjects, which requires further evaluation, characterization, and study to clarify the potential immune dysfunction by which PANS manifests and progresses.”

 

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.