Pediatricacute-onsetneuropsychiatricsyndrome(PANS) isaconditioncharacterized by theabrupt, dramaticonset of obsessive–compulsivedisorder (OCD) or eating restriction accompaniedbyequallyabruptandseverecomorbidneuropsychiatricsymptoms.PANDAS(pediatric autoimmuneneuropsychiatricdisorderassociatedwithstreptococcalinfection)isaheterogeneous syndromeidentifiedaspost-Streptococcuspyogenesinfection(β-hemolyticStreptococcusgroupA) complicationsregardingthecentralnervoussystemwithspecificinvolvementofneuropsychiatric andbehavioral skills. Inthefirstpartofourstudy,weshareourexperience inthetreatment ofagroupofextreme-grade(accordingtoCY-BOCSseverityscale)symptomaticpatientswith intravenousimmunoglobulin(IVIG),followingthemostrecentstudiesregardingthedosageofthe drug.Ourcontributionistoshareourexperiencemadeonasampleof55patientsallinthehighestlevel ofaseveritygrade. Inthesecondpartofourstudy,wealsoanalyzetheliteratureonPANS/PANDAS rehabilitationtherapy,sinceintheliteraturethereisnodiscussionofunionandcomparisononthis method.Objective:Thisstudyaimstoevaluatetheclinicalfeaturesofthepatientsobservedfrom differentItaliancohorts,withtheattemptatevaluatingclinicalresponsetoIVIGtreatmentinchildren withanextremeseveritygradeofPANS/PANDASdisease.Furthermore,afterhavinganalyzedthe literature,weproposerehabilitationtherapyasanaddedvaluetothepharmacologicaltreatment. MaterialsandMethods:Atotalof55patientswithadiagnosisofPANS/PANDAS,whobelongedtoan extremegradeofdisease,wereenrolled.AllpatientswereadministeredwithIVIGtreatmentat2g/kg perdayfortwoconsecutivedays.Results:Fromourstudy,anoticeableimprovement(untilcomplete remission)ofsymptomswasevidentforatleastoneyearin47outof55(85%)observedchildren, while11outofthese43(25%)showedanevidentsymptomsremissioninasingleattemptandthe remaining32(75%)requiredasecondadministrationtonoticealastingsymptomaticimprovement.

PANS/PANDAS: Clinical Experience in IVIG Treatment and State of the Art in Rehabilitation Approaches

Raffaele Falsaperla;
2020

Abstract

Pediatricacute-onsetneuropsychiatricsyndrome(PANS) isaconditioncharacterized by theabrupt, dramaticonset of obsessive–compulsivedisorder (OCD) or eating restriction accompaniedbyequallyabruptandseverecomorbidneuropsychiatricsymptoms.PANDAS(pediatric autoimmuneneuropsychiatricdisorderassociatedwithstreptococcalinfection)isaheterogeneous syndromeidentifiedaspost-Streptococcuspyogenesinfection(β-hemolyticStreptococcusgroupA) complicationsregardingthecentralnervoussystemwithspecificinvolvementofneuropsychiatric andbehavioral skills. Inthefirstpartofourstudy,weshareourexperience inthetreatment ofagroupofextreme-grade(accordingtoCY-BOCSseverityscale)symptomaticpatientswith intravenousimmunoglobulin(IVIG),followingthemostrecentstudiesregardingthedosageofthe drug.Ourcontributionistoshareourexperiencemadeonasampleof55patientsallinthehighestlevel ofaseveritygrade. Inthesecondpartofourstudy,wealsoanalyzetheliteratureonPANS/PANDAS rehabilitationtherapy,sinceintheliteraturethereisnodiscussionofunionandcomparisononthis method.Objective:Thisstudyaimstoevaluatetheclinicalfeaturesofthepatientsobservedfrom differentItaliancohorts,withtheattemptatevaluatingclinicalresponsetoIVIGtreatmentinchildren withanextremeseveritygradeofPANS/PANDASdisease.Furthermore,afterhavinganalyzedthe literature,weproposerehabilitationtherapyasanaddedvaluetothepharmacologicaltreatment. MaterialsandMethods:Atotalof55patientswithadiagnosisofPANS/PANDAS,whobelongedtoan extremegradeofdisease,wereenrolled.AllpatientswereadministeredwithIVIGtreatmentat2g/kg perdayfortwoconsecutivedays.Results:Fromourstudy,anoticeableimprovement(untilcomplete remission)ofsymptomswasevidentforatleastoneyearin47outof55(85%)observedchildren, while11outofthese43(25%)showedanevidentsymptomsremissioninasingleattemptandthe remaining32(75%)requiredasecondadministrationtonoticealastingsymptomaticimprovement.
2020
Pavone, Piero; Falsaperla, Raffaele; Cacciaguerra, Giovanni; Sapuppo, Annamaria; Chiaramonte, Rita; Lubrano, Riccardo; Messina, Giulia; Sciuto, Sarah; Sabino, Luca; Cocuzza, Salvatore; Maniaci, Antonino; Fontana, Alessandra; Marino, Lidia; Oliva, Claudia; Grazia Pappalardo, Maria; Vecchio, Michele
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2535691
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