Educational Series
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and gut microbiota composition: what do we know?
“The few studies available to date, regarding the gut microbiota composition in children with PANDAS, suggest that this group of patients may have an altered gut microbiota composition compared to healthy controls, as well as a different expression of specific metabolites involved in the inflammatory response, antibody production, and associated with brain function."
“Current treatments, including antibiotics and immunotherapies, are essential but may disrupt gut microbiota, necessitating careful management. A multidisciplinary approach is crucial for integrating new findings into clinical practice and optimizing treatment strategies to improve patient care and outcomes.”
Altered gut microbiota composition may contribute to the severity of neuropsychiatric symptoms in PANDAS patients.
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Only Test Of Its Kind
Three cases with chronic obsessive compulsive disorder report gains in wellbeing and function following rituximab treatment
According to the study, “The longitudinal treatment response is in line with a successfully addressed underlying immunological pathology. Furthermore, these cases suggest that benefit from immunotherapy, such as rituximab, is possible even after prolonged periods of illness.”
“Taken together, three individuals severely ill with previously treatment-resistant and probable autoimmune OCD were treated with five or six courses of rituximab. Symptoms and function improved markedly, and this was sustained for years.”
The authors conclude, that “rituximab treatment was followed by clear improvement in general psychiatric and OCD-specific symptoms.”
IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures
“The study found that six IVIG infusions lead to improvement in psychiatric symptom scores in PANS patients, including OCD and tics. Additionally, for the first time, data showing a decrease in pro-inflammatory monocytes and dendritic cells in these patients after the completion of IVIG treatment were presented.”
“Overall, the results of this study strengthen the conclusion that the active PANS state (high levels of OCD, tics, etc.) is associated with an inflammatory process and that the clinical symptoms and pro-inflammatory state improve with immunomodulation.”
“In the present study the effect of IVIG treatment on pro-inflammatory myeloid cell profiles in PANS patients was evaluated for the first time.”
Consultation for Utilization of the Panel
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