Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a specific autoimmune response to group-A streptococcal (GAS) infections in children and adolescents with a sudden onset of neuropsychiatric disorders including obsessive-compulsive disorder (OCD) or...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Adam Krouse, Huihua Li, Joseph A. Krenzer, William Nicholas Rose
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/a18e072a8f3442569fa19afd291fe3c4
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a18e072a8f3442569fa19afd291fe3c4
record_format	dspace
spelling	oai:doaj.org-article:a18e072a8f3442569fa19afd291fe3c42021-11-15T01:19:32ZPlasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)2090-683810.1155/2021/8697902https://doaj.org/article/a18e072a8f3442569fa19afd291fe3c42021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/8697902https://doaj.org/toc/2090-6838Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a specific autoimmune response to group-A streptococcal (GAS) infections in children and adolescents with a sudden onset of neuropsychiatric disorders including obsessive-compulsive disorder (OCD) or tic-like symptoms. We present a case report of a 27-year-old male patient who had lasting improvement with plasmapheresis, rituximab, and ceftriaxone. Our patient first developed sudden psychosis and confusion after GAS infections at age 17. He had elevated anti-streptolysin O (ASO) titers, negative urine drug screen, no ETOH in blood, normal CBC, normal TSH, normal salicylate, normal acetaminophen, and a normal head CT. The tentative diagnosis of PANDAS was made, and the patient was thereafter treated with antipsychotics, antibiotics, tonsillectomy, and IVIG which resulted in remissions and relapses of his neuropsychiatric symptoms. Once he reached age 27, he received a trial of therapeutic plasma exchange (TPE), rituximab, and ceftriaxone. This eventually resulted in sustained benefit and minimal fluctuations of his clinical symptoms. Our report is noteworthy in three ways.One, he is a 27-year-old adult with PANDAS.Two, he improved after TPE, rituximab, and ceftriaxone. Our literature search yielded minimal data on the use of plasmapheresis for nonteenage adults with PANDAS. Three, he had unusual symptoms of PANDAS, as the typical OCD and/or tic-like symptoms were not observed.Adam KrouseHuihua LiJoseph A. KrenzerWilliam Nicholas RoseHindawi LimitedarticlePsychiatryRC435-571ENCase Reports in Psychiatry, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychiatry RC435-571
spellingShingle	Psychiatry RC435-571 Adam Krouse Huihua Li Joseph A. Krenzer William Nicholas Rose Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
description	Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a specific autoimmune response to group-A streptococcal (GAS) infections in children and adolescents with a sudden onset of neuropsychiatric disorders including obsessive-compulsive disorder (OCD) or tic-like symptoms. We present a case report of a 27-year-old male patient who had lasting improvement with plasmapheresis, rituximab, and ceftriaxone. Our patient first developed sudden psychosis and confusion after GAS infections at age 17. He had elevated anti-streptolysin O (ASO) titers, negative urine drug screen, no ETOH in blood, normal CBC, normal TSH, normal salicylate, normal acetaminophen, and a normal head CT. The tentative diagnosis of PANDAS was made, and the patient was thereafter treated with antipsychotics, antibiotics, tonsillectomy, and IVIG which resulted in remissions and relapses of his neuropsychiatric symptoms. Once he reached age 27, he received a trial of therapeutic plasma exchange (TPE), rituximab, and ceftriaxone. This eventually resulted in sustained benefit and minimal fluctuations of his clinical symptoms. Our report is noteworthy in three ways.One, he is a 27-year-old adult with PANDAS.Two, he improved after TPE, rituximab, and ceftriaxone. Our literature search yielded minimal data on the use of plasmapheresis for nonteenage adults with PANDAS. Three, he had unusual symptoms of PANDAS, as the typical OCD and/or tic-like symptoms were not observed.
format	article
author	Adam Krouse Huihua Li Joseph A. Krenzer William Nicholas Rose
author_facet	Adam Krouse Huihua Li Joseph A. Krenzer William Nicholas Rose
author_sort	Adam Krouse
title	Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
title_short	Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
title_full	Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
title_fullStr	Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
title_full_unstemmed	Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
title_sort	plasmapheresis, rituximab, and ceftriaxone provided lasting improvement for a 27-year-old adult male with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (pandas)
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/a18e072a8f3442569fa19afd291fe3c4
work_keys_str_mv	AT adamkrouse plasmapheresisrituximabandceftriaxoneprovidedlastingimprovementfora27yearoldadultmalewithpediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandas AT huihuali plasmapheresisrituximabandceftriaxoneprovidedlastingimprovementfora27yearoldadultmalewithpediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandas AT josephakrenzer plasmapheresisrituximabandceftriaxoneprovidedlastingimprovementfora27yearoldadultmalewithpediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandas AT williamnicholasrose plasmapheresisrituximabandceftriaxoneprovidedlastingimprovementfora27yearoldadultmalewithpediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandas
_version_	1718428939997675520

Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)

Ejemplares similares