The Cunningham Panel, testing for autoantibodies associated with neuropsychiatric symptoms, correctly identifies a 15-year-old girl initially diagnosed with schizophrenia as suffering from a type of autoimmune encephalitis, known as pediatric acute-onset neuropsychiatric syndrome (PANS).
The girl's symptoms included psychosis, hallucinations, seizure-like "spells", catatonic movements, OCD, and anxiety. Psychiatric medications did not help her symptoms. She was treated successfully with immune modulating therapy (plasmapheresis).
Two weeks after treatment, the young girl resumed all her normal activities, which included playing tennis.
Case Report: An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment
Study link: www.hindawi.co...
Study highlights: www.moleculera...
===========================
Transcript:
Dr. Shimasaki:
There was a case of a patient diagnosed with schizophrenia. A 15-year-old girl who was treated and in and out of treatment facilities.
Visual:
She was originally diagnosed and treated unsuccessfully for schizophrenia, psychosis, severe anxiety and depression. A more in-depth history revealed that she had an abrupt onset of symptoms with remote acute infections exhibited many characteristics of obsessive compulsive disorder (OCD) with rituals.
Dr. Shimasaki:
But her symptoms were uncontrollable. The physician referred her to an immunologist. And the immunologist knew about our testing and submitted a blood sample for us to test.
Visual:
She had acute onset of “seizure-like spells,” psychotic thinking, and seemingly schizophrenia symptoms, manifesting as auditory hallucinations and catatonic movements.
Dr. Shimasaki:
The patient was positive and began using immunomodulatory therapy.
Visual:
She was able to be weaned off of olanzapine and resume many of her normal activities, including tennis within 2 weeks after plasmapheresis.
Dr. Shimasaki:
And within a few weeks, this patient, a 15-year-old girl who was diagnosed with schizophrenia, in and out of treatment facilities was back home normal and playing tennis and off of all psychiatric medications.
Visual:
After 1 course of plasmapheresis was administered (7 treatments every other day), the patient had complete resolution of her psychotic, OCD and anxiety symptoms.
This is dramatic. All these cases may not be so dramatic but the take home message is that once the underlying root cause can be identified, then clinicians can treat the underlying root with the proper medications.
This study was published in a peer-reviewed journal and there are many more [cases] like this.
11 окт 2024
