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10.1186/s12883-018-1063-y

http://scihub22266oqcxt.onion/10.1186/s12883-018-1063-y
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C5930772!5930772 !29720109
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suck abstract from ncbi


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pmid29720109
      BMC+Neurol 2018 ; 18 (1 ): 60
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  • Altered cerebral glucose metabolism normalized in a patient with a pediatric autoimmune neuropsychiatric disorder after streptococcal infection (PANDAS)-like condition following treatment with plasmapheresis: a case report #MMPMID29720109
  • Nave AH ; Harmel P ; Buchert R ; Harms L
  • BMC Neurol 2018[May]; 18 (1 ): 60 PMID29720109 show ga
  • BACKGROUND: Pediatric autoimmune neuropsychiatric disorder after streptococcal infection (PANDAS) is a specific autoimmune response to group-A streptococcal infections in children and adolescents with a sudden onset of obsessive-compulsive disorders or tic-like symptoms. Cerebral metabolic changes of patients have not yet been observed. CASE PRESENTATION: We present a case of an 18-year old male with a PANDAS-like condition after developing tic-like symptoms and involuntary movements three weeks after cardiac surgery. The patient had suffered from pharyngotonsillitis before the symptoms started. The anti-streptolysin O (ASO) titer was elevated (805 kU/l). Antibiotic therapy did not improve his condition. Intravenous immunoglobulins and high-dose cortisone therapy had minor beneficial effects on his involuntary movements. 18F-Fluorodeoxyglucose positron emission tomography/ computer tomography (18F-FDG PET/CT) demonstrated pronounced hypermetabolism of the basal ganglia and cortical hypometabolism. The patient was treated with five cycles of plasmapheresis. A marked clinical improvement was observed after four months. Cerebral metabolic alterations had completely normalized. CONCLUSIONS: This is the first report of cerebral metabolic changes observed on FDG-PET/CT in a patient with a PANDAS-like condition with a normalization following immunomodulatory treatment. Cerebral FDG-PET/CT might be a promising tool in the diagnosis of PANDAS.
  • |Adolescent [MESH]
  • |Anti-Bacterial Agents/therapeutic use [MESH]
  • |Autoimmune Diseases/etiology/physiopathology/*therapy [MESH]
  • |Autoimmunity [MESH]
  • |Brain/metabolism/*physiopathology [MESH]
  • |Glucose/*metabolism [MESH]
  • |Humans [MESH]
  • |Male [MESH]
  • |Obsessive-Compulsive Disorder/etiology/physiopathology/therapy [MESH]
  • |Plasmapheresis/*methods [MESH]
  • |Positron Emission Tomography Computed Tomography [MESH]
  • |Respiratory Tract Infections/complications [MESH]


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