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Pediatric autoimmune neuropsychiatric

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https://www.readbyqxmd.com/read/28750400/a-dopamine-hypothesis-of-autism-spectrum-disorder
#1
Denis Pavăl
Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders characterized by social deficits and stereotyped behaviors. While several theories have emerged, the pathogenesis of ASD remains unknown. Although studies report dopamine signaling abnormalities in autistic patients, a coherent dopamine hypothesis which could link neurobiology to behavior in ASD is currently lacking. In this paper, we present such a hypothesis by proposing that autistic behavior arises from dysfunctions in the midbrain dopaminergic system...
July 28, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28722481/clinical-management-of-pediatric-acute-onset-neuropsychiatric-syndrome-part-i-psychiatric-and-behavioral-interventions
#2
Margo Thienemann, Tanya Murphy, James Leckman, Richard Shaw, Kyle Williams, Cynthia Kapphahn, Jennifer Frankovich, Daniel Geller, Gail Bernstein, Kiki Chang, Josephine Elia, Susan Swedo
OBJECTIVE: This article outlines the consensus guidelines for symptomatic treatment for children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Syndrome Associated with Streptococcal Infection (PANDAS). METHODS: Extant literature on behavioral, psychotherapeutic, and psychopharmacologic treatments for PANS and PANDAS was reviewed. Members of the PANS Research Consortium pooled their clinical experiences to find agreement on treatment of PANS and PANDAS symptoms...
July 19, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28714753/pediatric-acute-onset-neuropsychiatric-syndrome-response-to-oral-corticosteroid-bursts-an-observational-study-of-patients-in-an-academic-community-based-pans-clinic
#3
Kayla Brown, Cristan Farmer, Bahare Farhadian, Joseph Hernandez, Margo Thienemann, Jennifer Frankovich
BACKGROUND: Sudden-onset severe obsessive-compulsive symptoms and/or severely restrictive food intake with at least two coinciding, similarly debilitating neuropsychiatric symptoms define Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). When associated with Group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS). An abnormal immune response to infection and subsequent neuroinflammation is postulated to play an etiologic role...
July 17, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28696786/effect-of-early-and-prophylactic-nonsteroidal-anti-inflammatory-drugs-on-flare-duration-in-pediatric-acute-onset-neuropsychiatric-syndrome-an-observational-study-of-patients-followed-by-an-academic-community-based-pediatric-acute-onset-neuropsychiatric-syndrome
#4
Kayla D Brown, Cristan Farmer, G Mark Freeman, Ellen J Spartz, Bahare Farhadian, Margo Thienemann, Jennifer Frankovich
INTRODUCTION: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by the sudden onset of severe obsessive-compulsive symptoms and/or eating restriction along with at least two coinciding neuropsychiatric symptoms. When associated with group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS). An abnormal immune response to infection and subsequent neuroinflammation is postulated to play an etiologic role...
July 11, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28696783/course-of-neuropsychiatric-symptoms-after-introduction-and-removal-of-nonsteroidal-anti-inflammatory-drugs-a-pediatric-observational-study
#5
Ellen J Spartz, G Mark Freeman, Kayla Brown, Bahare Farhadian, Margo Thienemann, Jennifer Frankovich
OBJECTIVE: Accumulating evidence suggests that anti-inflammatory interventions can modulate neuropsychiatric symptoms. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by an abrupt and dramatic onset of obsessive-compulsive (OC) symptoms and/or severely restrictive food intake and at least two coinciding, equally debilitating neuropsychiatric symptoms. When associated with group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS)...
July 11, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28538981/association-of-streptococcal-throat-infection-with-mental-disorders-testing-key-aspects-of-the-pandas-hypothesis-in-a-nationwide-study
#6
Sonja Orlovska, Claus Høstrup Vestergaard, Bodil Hammer Bech, Merete Nordentoft, Mogens Vestergaard, Michael Eriksen Benros
Importance: Streptococcal infection has been linked with the development of obsessive-compulsive disorder (OCD) and tic disorders, a concept termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). However, previous studies of this association have been small, and the results have been conflicting. Objective: To investigate the risk of mental disorders, specifically OCD and tic disorders, after a streptococcal throat infection...
July 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28498087/an-expert-opinion-on-pandas-pans-highlights-and-controversies
#7
Francesca Chiarello, Silvia Spitoni, Eric Hollander, Marco Matucci Cerinic, Stefano Pallanti
OBJECTIVES: 'Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections' (PANDAS) identified a unique subgroup of patients with abrupt onset of obsessive compulsive disorder (OCD) symptoms clinically related to Streptococcus infection and accompanied by neuropsychological and motor symptoms. After almost 20 years, PANDAS has not been accepted as distinct disorder and new criteria for paediatric acute-onset neuropsychiatric syndrome (PANS) have been replaced it, highlighting the fact that several agents rather than only Streptococcus might be involved...
June 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28422636/impact-of-pans-and-pandas-exacerbations-on-occupational-performance-a-mixed-methods-study
#8
Janice Trigilio Tona, Sutanuka Bhattacharjya, Denise Calaprice
OBJECTIVE: Pediatric acute-onset neuropsychiatric syndrome (PANS) includes pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and involves sudden-onset neuropsychiatric symptoms, including obsessions, compulsions, sensory difficulties, and dysgraphia after infection or other triggers. Our objective was to identify problems with areas of occupation, body functions, and performance skills during exacerbations. METHOD: In this online retrospective study, based on the Occupational Therapy Practice Framework: Domain and Process (2nd ed...
May 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28140619/a-survey-of-pediatric-acute-onset-neuropsychiatric-syndrome-characteristics-and-course
#9
Denise Calaprice, Janice Tona, Ellisa Carla Parker-Athill, Tanya K Murphy
OBJECTIVE: To date, studies in the area of pediatric acute-onset neuropsychiatric syndrome (PANS; including pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection [PANDAS] and pediatric infection-triggered neuropsychiatric disorder [PITAND]) have been relatively small and hence unable to comprehensively address questions of disease heterogeneity (e.g., by age, gender), comorbidities, and progression. In this study, we investigated an internet survey sample to more fully characterize the phenotypic traits; medical, family, and developmental history; functional challenges; and clinical course associated with PANS...
January 31, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28134038/outcomes-of-847-childhood-onset-systemic-lupus-erythematosus-patients-in-three-age-groups
#10
S R M Lopes, N W S Gormezano, R C Gomes, N E Aikawa, R M R Pereira, M T Terreri, C S Magalhães, J C Ferreira, E M Okuda, A P Sakamoto, A M E Sallum, S Appenzeller, V P L Ferriani, C M Barbosa, S Lotufo, A A Jesus, L E C Andrade, L M A Campos, E Bonfá, C A Silva
Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (<6 years), group B school age (≥6 and <12 years) and group C adolescent (≥12 and <18 years). Methods An observational cohort study was performed in ten pediatric rheumatology centers, including 847 cSLE patients. Results Group A had 39 (4%), B 395 (47%) and C 413 (49%). Median disease duration was significantly higher in group A compared to groups B and C (8...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28121463/prevalence-of-acute-onset-subtypes-in-pediatric-obsessive-compulsive-disorder
#11
Fern Jaspers-Fayer, Sang Hun Jerry Han, Elaine Chan, Katherine McKenney, Annie Simpson, Andrea Boyle, Rhonda Ellwyn, S Evelyn Stewart
BACKGROUND: Pediatric obsessive-compulsive disorder (OCD) is a common, debilitating illness. When childhood OCD symptom onset is described as acute and severe, diagnostic criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) should be considered. However, the frequency and differentiating features of these putative syndromes within pediatric OCD remain poorly understood...
May 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28025607/tonsillectomy-remains-a-questionable-option-for-pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections-pandas
#12
REVIEW
Jochen P Windfuhr
Background: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive disorders (OCD) or tic disorders associated with streptococcal infections. Because otolaryngologists examine a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was conducted to evaluate the efficacy of TE in patients presenting with verified PANDAS. Material and methods: A PubMed review was performed using search terms "tonsillectomy" and "PANDAS", "OCD", "compulsive" "pediatric autoimmune", "chorea" and "tic" limited by publication date of January 1, 1995, to July 31, 2015...
2016: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/28009765/autoimmune-encephalitides-a-broadening-field-of-treatable-conditions
#13
REVIEW
Bernadette Kalman
BACKGROUND: Neurology has been continuously transforming by the refinement of molecular diagnostics and the development of disease-modifying treatments. The discovery of new antibody markers has elucidated the pathogenesis, provided the means of diagnostics, and offered cure or treatment for several immune-mediated neurological and neuropsychiatric disorders. The identification of pathogenic and marker autoantibodies has also facilitated defining the associated phenotypic spectra and the overlap among the phenotypes linked to individual immune markers...
January 2017: Neurologist
https://www.readbyqxmd.com/read/27992257/agitation-management-in-pediatric-males-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#14
Lauren T Schumacher, Andrea P Mann, James G MacKenzie
OBJECTIVES: Severe agitation is a common symptom in pediatric cases of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis-an autoimmune encephalitis with prominent neuropsychiatric symptoms. Agitation is a major barrier to treatment of the underlying disease process and increases patients' risk of harming themselves and others. Furthermore, male patients often have undetectable tumors and are especially at risk for extended hospitalization, but have been infrequently studied...
December 2016: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/27663941/randomized-controlled-trial-of-intravenous-immunoglobulin-for-pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections
#15
RANDOMIZED CONTROLLED TRIAL
Kyle A Williams, Susan E Swedo, Cristan A Farmer, Heidi Grantz, Paul J Grant, Precilla D'Souza, Rebecca Hommer, Liliya Katsovich, Robert A King, James F Leckman
OBJECTIVE: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are hypothesized to occur as a result of cross-reactive antibodies produced in response to group A streptococcal infections. Previous research suggests that immunomodulatory therapies, such as intravenous immunoglobulin (IVIG), may lead to rapid and sustained symptom improvement in patients with PANDAS. METHOD: A total of 35 children meeting criteria for PANDAS and moderate to severe obsessive-compulsive disorder (OCD) were enrolled in a randomized-entry, double-blind, placebo-controlled, 6-week trial of IVIG (1 g/kg/day on 2 consecutive days), followed by optional open-label treatment for nonresponders, with follow-up at 12 and 24 weeks...
October 2016: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/27663937/intravenous-immunoglobulin-is-not-an-effective-treatment-for-pediatric-autoimmune-neuropsychiatric-disorder-associated-with-streptococcal-infection-obsessive-compulsive-disorder
#16
EDITORIAL
Jonathan W Mink
No abstract text is available yet for this article.
October 2016: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/27619047/pandas-a-systematic-review-of-treatment-options
#17
REVIEW
Zachary Farhood, Adrian A Ong, Christopher M Discolo
INTRODUCTION: Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) is a rare but important condition for pediatric otolaryngologists to recognize. Several treatment options exist including tonsillectomy, antibiotic treatment/prophylaxis, intravenous immunoglobulin (IVIG), and psychiatric medications/therapy. METHODS: A systematic review of the PubMed, EMBASE, and Scopus databases was performed searching for articles that focused exclusively on the aforementioned treatment modalities in the PANDAS population...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27445678/pediatric-autoimmune-disorders-associated-with-streptococcal-infections-and-tourette-s-syndrome-in-preclinical-studies
#18
REVIEW
Chiara Spinello, Giovanni Laviola, Simone Macrì
Accumulating evidence suggests that Tourette's Syndrome (TS) - a multifactorial pediatric disorder characterized by the recurrent exhibition of motor tics and/or vocal utterances - can partly depend on immune dysregulation provoked by early repeated streptococcal infections. The natural and adaptive antibody-mediated reaction to streptococcus has been proposed to potentially turn into a pathological autoimmune response in vulnerable individuals. Specifically, in conditions of increased permeability of the blood brain barrier (BBB), streptococcus-induced antibodies have been proposed to: (i) reach neuronal targets located in brain areas responsible for motion control; and (ii) contribute to the exhibition of symptoms...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27370066/-evaluation-of-a-neuropsychiatric-disorder-from-pandas-to-pans-and-cans
#19
Muharrem Burak Baytunca, Tuğba Donuk, Serpil Erermiş
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) syndrome is a disorder seen before adolescence that possesses an abrupt onset of obsessive-compulsive disorder symptoms and/or tics. Swedo and colleagues defined this disorder in 1998 as a syndrome related to Group A streptoccoccus (GAS) infection with neurological issues, such as motor hyperactivation and choreiform movements. The progress of the disorder may be described as wax-and-waning, apart from abrupt onset, and this relapse and remission course is associated with exacerbating infections, according to the creators of PANDAS syndrome...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/27315236/atomoxetine-use-in-attention-deficit-hyperactivity-disorder-and-comorbid-tic-disorder-in-pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections
#20
Sevcan Karakoç Demirkaya, Mithat Demirkaya, Canan Yusufoğlu, Elif Akın
Attention-deficit/hyperactivity disorder (ADHD) is a common comorbid disease in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), in which tic-like involuntary movements are frequently seen clinical conditions. In contrast to psychostimulants, atomoxetine is considered as having minimal effects on tics. Here we report two cases with ADHD and PANDAS who were treated with atomoxetine for their ADHD and comorbid tics.
February 2017: Journal of Child and Adolescent Psychopharmacology
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