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Neuropsychiatric symptoms following sore throat in a young boy.
- Source :
-
BMJ case reports [BMJ Case Rep] 2019 Jan 22; Vol. 12 (1). Date of Electronic Publication: 2019 Jan 22. - Publication Year :
- 2019
-
Abstract
- A previously healthy 6-year-old boy was referred to us by his primary provider, with a history of sudden onset behavioural abnormalities including irritability, sleep disturbance and anxiety. Physical examination revealed no significant findings; further analyses were not suggestive of meningitis, encephalitis, metabolic abnormalities, toxicity or any other obvious cause. On rechecking the patient's history, an episode of throat pain 1 week prior to the symptom onset was noted. Therefore, the possibility of paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) was considered. The antistreptolysin O titre was high (1078 IU/mL), and it increased to 1194 IU/mL 4 weeks later, leading to a diagnosis of PANDAS. He was started on ampicillin and administered one dose of intravenous immunoglobulin. His abnormal behaviours subsided and he returned to a normal state within 48 hours of treatment. This report aims to provide insights into the symptomology and diagnosis of PANDAS in children.<br />Competing Interests: Competing interests: None declared.<br /> (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Administration, Intravenous
Aftercare
Ampicillin administration & dosage
Ampicillin therapeutic use
Anti-Bacterial Agents therapeutic use
Antistreptolysin analysis
Autoimmune Diseases drug therapy
Behavioral Symptoms diagnosis
Behavioral Symptoms immunology
Child
Diagnosis, Differential
Humans
Immunoglobulins, Intravenous administration & dosage
Immunoglobulins, Intravenous therapeutic use
Male
Obsessive-Compulsive Disorder
Pharyngitis diagnosis
Pharyngitis immunology
Pharyngitis microbiology
Rare Diseases
Streptococcal Infections complications
Streptococcal Infections drug therapy
Treatment Outcome
Autoimmune Diseases diagnosis
Behavioral Symptoms etiology
Pharyngitis complications
Streptococcal Infections diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 30674494
- Full Text :
- https://doi.org/10.1136/bcr-2018-227540