Therapeutic plasma exchange in adolescent and adult patients with autoimmune neuropsychiatric disorders associated with streptococcal infections

J Clin Apher. 2022 Dec;37(6):597-599. doi: 10.1002/jca.22023. Epub 2022 Oct 17.

Abstract

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal (PANDAS) infections and pediatric acute-onset neuropsychiatric syndrome (PANS) are typically diagnosed in childhood. Therapeutic plasma exchange (TPE) has been recommended to remove relevant antibodies and treat symptomatic presentations in children and adolescents, but there are no studies that evaluate the use of TPE in patients who are diagnosed later in life. It is therefore unclear if using an accepted treatment for pediatric PANS/PANDAS patients would be beneficial in adults with prolonged PANDAS/PANS symptomatic histories. This study investigated 16 late adolescent and adult PANDAS/PANS patients' responses to TPE. Improvement was noted in over half of the patients with available follow-up information.

MeSH terms

  • Adolescent
  • Autoimmune Diseases* / therapy
  • Child
  • Humans
  • Obsessive-Compulsive Disorder* / diagnosis
  • Obsessive-Compulsive Disorder* / drug therapy
  • Plasma Exchange
  • Streptococcal Infections* / complications
  • Streptococcal Infections* / therapy

Supplementary concepts

  • Pediatric acute-onset neuropsychiatric syndrome
  • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections