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Pediatric autoimmune neuropsychiatric disorder

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https://www.readbyqxmd.com/read/29735114/tic-disorders-and-pandas
#1
Joanna S Blackburn
Tics are the most common movement disorder in childhood and are a frequent reason for referral to child neurology clinics. The purpose of this review is to examine the phenomenology of tics, discuss what is known regarding their genetic and pathophysiological causes and to evaluate current treatment options. The evidence for the evaluation and treatment of the controversial diagnosis of pediatric autoimmune neuropsychiatric disorders associated with group A streptococci (PANDAS) will also be reviewed. With improved understanding of tic disorders, their etiology and response to current treatment options, we may be able to more effectively diagnose them and identify novel treatment strategies...
April 2018: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29722936/antibiotics-for-pandas-limited-evidence-review-and-putative-mechanisms-of-action
#2
Elisabetta Burchi, Stefano Pallanti
Objective: Antibiotics have been used extensively by clinicians to treat patients with PANDAS or PANS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, respectively). This review examines the best-quality evidence supporting the practice-based use of antibiotics in these psychiatric conditions. Data Sources: PubMed was searched for English-language articles published between January 1994 and July 2017 using the search terms [PANDAS OR PANS OR new-onset pediatric OCD] AND [antibiotics OR macrolides OR beta-lactams]...
May 3, 2018: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29720109/altered-cerebral-glucose-metabolism-normalized-in-a-patient-with-a-pediatric-autoimmune-neuropsychiatric-disorder-after-streptococcal-infection-pandas-like-condition-following-treatment-with-plasmapheresis-a-case-report
#3
A H Nave, P Harmel, R Buchert, L Harms
BACKGROUND: Pediatric autoimmune neuropsychiatric disorder after streptococcal infection (PANDAS) is a specific autoimmune response to group-A streptococcal infections in children and adolescents with a sudden onset of obsessive-compulsive disorders or tic-like symptoms. Cerebral metabolic changes of patients have not yet been observed. CASE PRESENTATION: We present a case of an 18-year old male with a PANDAS-like condition after developing tic-like symptoms and involuntary movements three weeks after cardiac surgery...
May 2, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29689421/immune-system-and-obsessive-compulsive-disorder
#4
REVIEW
Donatella Marazziti, Federico Mucci, Leonardo F Fontenelle
BACKGROUND: Recently, much attention has been devoted to the possible alterations of the immune system in obsessive-compulsive disorder (OCD). Therefore, the aim of this paper was to review the current literature on the relationships between OCD and immune system. METHODS: A PubMed and Google Scholar search was performed with specific keywords. RESULTS: In the childhood, much emphasis has been given to the relationship between group A Streptococcus (GAS) infection and the development of a group of clinical syndromes characterized by neuropsychiatric symptoms known as "pediatric autoimmune neuropsychiatric disorders associated with streptococcus" (PANDAS)...
April 13, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29686658/gut-microbiota-profiling-and-gut-brain-crosstalk-in-children-affected-by-pediatric-acute-onset-neuropsychiatric-syndrome-and-pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections
#5
Andrea Quagliariello, Federica Del Chierico, Alessandra Russo, Sofia Reddel, Giulia Conte, Loris R Lopetuso, Gianluca Ianiro, Bruno Dallapiccola, Francesco Cardona, Antonio Gasbarrini, Lorenza Putignani
Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) are conditions that impair brain normal neurologic function, resulting in the sudden onset of tics, obsessive-compulsive disorder, and other behavioral symptoms. Recent studies have emphasized the crosstalk between gut and brain, highlighting how gut composition can influence behavior and brain functions. Thus, the present study investigates the relationship between PANS/PANDAS and gut microbiota ecology...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29671499/poststreptococcal-illness-recognition-and-management
#6
David L Maness, Michael Martin, Gregg Mitchell
Group A beta-hemolytic streptococcus can cause several postinfectious, nonsuppurative immune- mediated diseases including acute rheumatic fever, poststreptococcal reactive arthritis, pediatric autoimmune neuropsychiatric disorders, and poststreptococcal glomerulonephritis. Except for sporadic outbreaks, poststreptococcal autoimmune syndromes occur most commonly in sub-Saharan Africa, India, Australia, and New Zealand. Children younger than three years are rarely affected by group A streptococcus pharyngitis or rheumatic fever, and usually do not require testing...
April 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29398245/cans-childhood-acute-neuropsychiatric-syndromes
#7
REVIEW
Federica Zibordi, Zorzi Giovanna, Carecchio Miryam, Nardocci Nardo
The terms Pediatric Autoimmune Neuropsychiatric disorders associated with streptococcal infections (PANDAS), Pediatric acute-onset neuropsychiatric Syndrome (PANS), and Childhood Acute Neuropsychiatric Symptoms (CANS) have been used to describe certain acute onset neuropsychiatric pediatric disorders. This clinical characteristic was unusually abrupt onset of obsessive compulsive symptoms and/or severe eating restrictions and concomitant cognitive, behavioral or neurological symptoms. Because the CANS/PANS criteria define a broad spectrum of neuropsychiatric conditions, the syndrome is presumed to result from a variety of disease mechanisms and to have multiple etiologies, ranging from postinfectious autoimmune and neuroinflammatory disorders to toxic, endocrine or metabolic disorders...
March 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29303953/voltage-gated-potassium-channel-antibody-autoimmune-encephalopathy-presenting-with-isolated-psychosis-in-an-adolescent
#8
David A Kahn
Antibody-mediated encephalopathies associated with serum or cerebrospinal fluid antibodies directed against neuronal structures may present with a multitude of neuropsychiatric syndromes. Although some of the antibody-driven conditions are now well recognized in adults (eg, N-methyl-D-aspartate receptor antibody encephalitis), the spectrum of neuropsychiatric manifestations in the pediatric population is less clear. Psychosis, confusion, catatonia, and additional behavioral changes, along with seizures, encephalopathy, and movement disorders, may be initial manifestations or concurrent features in all age groups...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29303952/voltage-gated-potassium-channel-antibody-autoimmune-encephalopathy-presenting-with-isolated-psychosis-in-an-adolescent
#9
Natalie C Pon, Kimberly M Houck, Eyal Muscal, Sindhu A Idicula
Antibody-mediated encephalopathies associated with serum or cerebrospinal fluid antibodies directed against neuronal structures may present with a multitude of neuropsychiatric syndromes. Although some of the antibody-driven conditions are now well recognized in adults (eg, N-methyl-D-aspartate receptor antibody encephalitis), the spectrum of neuropsychiatric manifestations in the pediatric population is less clear. Psychosis, confusion, catatonia, and additional behavioral changes, along with seizures, encephalopathy, and movement disorders, may be initial manifestations or concurrent features in all age groups...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29233751/differential-binding-of-antibodies-in-pandas-patients-to-cholinergic-interneurons-in-the-striatum
#10
Luciana R Frick, Maximiliano Rapanelli, Kantiya Jindachomthong, Paul Grant, James F Leckman, Susan Swedo, Kyle Williams, Christopher Pittenger
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus, or PANDAS, is a syndrome of acute childhood onset of obsessive-compulsive disorder and other neuropsychiatric symptoms in the aftermath of an infection with Group A beta-hemolytic Streptococcus (GABHS). Its pathophysiology remains unclear. PANDAS has been proposed to result from cross-reactivity of antibodies raised against GABHS with brain antigens, but the targets of these antibodies are unclear and may be heterogeneous. We developed an in vivo assay in mice to characterize the cellular targets of antibodies in serum from individuals with PANDAS...
March 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29119912/the-glutamate-and-the-immune-systems-new-targets-for-the-pharmacological-treatment-of-ocd
#11
Donatella Marazziti, Umberto Albert, Federico Mucci, Armando Piccinni
BACKGROUND: In the last decades the pharmacological treatment of obsessive-compulsive disorder (OCD) has been significantly promoted by the effectiveness of selective serotonin (5-HT) reuptake inhibitors (SSRIs) and the subsequent development of the 5-HT hypothesis of OCD. However, since a large majority of patients (between 40% and 60 %) do not respond to SSRIs or strategies based on the modulation of the 5-HT system, it is now essential to search for other possible therapeutic targets...
November 8, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29119300/longitudinal-outcomes-of-children-with-pediatric-autoimmune-neuropsychiatric-disorder-associated-with-streptococcal-infections-pandas
#12
Jill Leon, Rebecca Hommer, Paul Grant, Cristan Farmer, Precilla D'Souza, Riley Kessler, Kyle Williams, James F Leckman, Susan Swedo
Little is known about the natural history of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS). This study prospectively followed 33 children with PANDAS for up to 4.8 years (mean 3.3 ± 0.7 years) after enrollment in a 24-week randomized, double-blind, placebo-controlled trial of intravenous immunoglobulin (IVIG) (N = 35). Fourteen of eighteen children randomized to placebo received open label IVIG 6 weeks after the blinded infusion, so follow-up results reported below largely reflect outcomes in a population of children who received at least one dose of IVIG...
November 8, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/29112476/cross-sectional-evaluation-of-plasma-vitamin-d-levels-in-a-large-cohort-of-italian-patients-with-pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections
#13
Stefano Stagi, Gemma Lepri, Donato Rigante, Marco Matucci Cerinic, Fernanda Falcini
BACKGROUND: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are immune-mediated diseases characterized by obsessive-compulsive symptoms and/or tics triggered by group A Streptococcus infections. Despite the well-known action of 25-hydroxyvitamin D [25(OH)D] on different conditions driven by systemic inflammation, there are no data about the 25(OH)D status in patients with PANDAS. AIMS: To evaluate plasma 25(OH)D levels in a large cohort of children and adolescents with PANDAS and comparing the results with healthy controls...
March 2018: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28919236/biomarkers-for-diagnosis-of-pediatric-acute-neuropsychiatric-syndrome-pans-sensitivity-and-specificity-of-the-cunningham-panel
#14
Eva Hesselmark, Susanne Bejerot
OBJECTIVE: Pediatric Acute Neuropsychiatric Syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are conditions marked by sudden onset of obsessive-compulsive disorder (OCD), tics, or avoidant/restrictive food intake in combination with multiple psychiatric symptoms. A diagnosis of PANS or PANDAS may be supported by the Cunningham Panel, a commercially available set of immunologic assays currently in clinical use. However, the relationship between Cunningham Panel results and patient symptoms remains unclear...
November 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28904568/pediatric-autoimmune-encephalitis
#15
REVIEW
Massimo Barbagallo, Giovanna Vitaliti, Piero Pavone, Catia Romano, Riccardo Lubrano, Raffaele Falsaperla
Autoimmune (antibody mediated) encephalitis (AE) is emerging as a more common cause of pediatric encephalopathy than previously thought. The autoimmune process may be triggered by an infection, vaccine, or occult neoplasm. In the latter case, onconeural autoantibodies are directed against intracellular neuronal antigens, but a recent heterogeneous group of encephalitic syndromes has been found not to have underlying tumor but is associated with autoantibodies to the neuronal surface or synaptic antigens. Neuropsychiatric symptoms are very common in autoimmune encephalopathy; as a result, affected children may be initially present to psychiatrists...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28841275/neuropsychiatric-manifestations-of-pediatric-nmda-receptor-autoimmune-encephalitis-a-case-series-from-a-tertiary-care-center-in-india
#16
Salah Basheer, Madhu Nagappa, Anita Mahadevan, Parayil Sankaran Bindu, Arun B Taly, Satish Chandra Girimaji
Objective: Although psychiatric manifestations are one of the most common presentations of pediatric N-methyl-D-aspartate receptor (NMDAR) encephalitis, there is a lack of studies that characterize psychiatric aspects of this disorder. This study was designed to address this gap. Methods: Initial clinical presentations including psychiatric symptoms, treatment details, and outcome with respect to psychiatric symptoms were collected from medical case records of children aged less than 18 years with seropositive NMDAR encephalitis from a single tertiary care center (May 2010-November 2016)...
August 17, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28750400/a-dopamine-hypothesis-of-autism-spectrum-disorder
#17
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...
2017: Developmental Neuroscience
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
#18
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...
September 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
#19
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...
September 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
#20
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)...
September 2017: Journal of Child and Adolescent Psychopharmacology
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