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

SUMMARY

Therapeutic plasma exchange in adolescent and adult patients with autoimmune neuropsychiatric disorders associated with streptococcal infections, investigated the potential benefits of therapeutic plasma exchange (TPE) in adolescent and adult patients diagnosed with PANDAS or PANS.

According to the 2019 American Society for Apheresis guidelines, the use of therapeutic plasma exchange (TPE), a procedure that removes harmful autoantibodies from the bloodstream, in PANDAS patients with an exacerbation carries a category II indication, denoting it as a second line therapy. While the conditions PANDAS and PANS are often diagnosed in childhood, some patients continue to experience severe neuropsychiatric symptoms into adolescence and adulthood. This study reviewed 16 cases, with patients receiving a PANS or PANDAS diagnosis between the ages of 11 and 22, and a median age of 16. At the time of the study, their ages ranged from 14 to 41. Prior to TPE, most patients at some point had received other PANDAS/PANS-oriented treatments, such as antibiotics and steroids

The study found that more than half of those with available follow-up data experienced clinical improvements, including reductions in obsessive-compulsive symptoms, anxiety, and cognitive dysfunction. Notably, no adverse reactions to TPE were reported. These findings highlight the potential of TPE as a therapeutic approach for adolescent and adult PANDAS/PANS patients.

LINK TO PAPER: https://doi.org/10.1002/jca.22023