Abstract
For two decades, pediatric autoimmune neuropsychiatric disorder associated with group a beta hemolytic streptococcal infection (PANDAS) has been treated with high-dose intravenous immune globulin (IVIg) therapy based upon the understanding that the disorder is partly due to post-infectious dysimmunity.
Highlights
For two decades, pediatric autoimmune neuropsychiatric disorder associated with group a beta hemolytic streptococcal infection (PANDAS) has been treated with high-dose intravenous immune globulin (IVIg) therapy based upon the understanding that the disorder is partly due to postinfectious dysimmunity
Sixty percent of children showed overall clinical improvement, 24% achieved remission of neuropsychiatric symptoms at final assessment, 9% were unchanged, and none were worse following IVIg therapy at doses between 1.0 and 2.0 grams per kilogram administered every 1 to 2 months for a mean duration of 15.3 months for refractory neuropsychiatric symptoms associated with pediatric infection-triggered autoimmune neuropsychiatric disorders (PANDAS)
Children with PANDAS, often with baseline humoral immune deficiency derive a favorable response to IVIg in PANDAS at 12 months follow up consistent with its role in Ig replacement and immune modulation
Summary
A search for publications documenting the experience of PANDAS treated with IVIg therapy was carried out in the English-speaking medical literature. This yielded seven articles comprising an observational study (114 patients), a randomized control trial (9 patients), five small case series (21 patients), and a single case abstract, together documenting the experience of 145 published children who met established criteria for the diagnosis of PANDAS and were treated with IVIg therapy for neuropsychiatric symptoms. An analysis of their findings was performed contrasting and combining clinical characteristics and outcomes of cases in each study, and generalizing information with mean values for continuous variables and percentages for character values
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