ANTINEURONAL BIOMARKERS HELP DIAGNOSE ENCEPHALITIS IN CHILDREN
The results of this study strongly suggest that both PANDAS and Sydenham Chorea are provoked by cross reactive anti-neuronal antibodies. “Our results suggest that the panel of four antineuronal antibodies and CaMKII activation assays successfully identify acute illness in PANDAS, providing opportunities for rapid and accurate diagnosis and treatment,” the authors conclude.
Lyme disease and the immune system: elevated neuronal autoantibodies associated with persistent symptoms
This study, which examines Lyme disease and the immune system, illustrates molecular mimicry targeting neural tissue after Borrelia burgdorferi (Bb) infection. The authors conclude that patients with Lyme disease have a greater frequency of certain anti-neuronal autoantibodies and functional neuronal activation compared to community controls without a history of Lyme disease.
Study demonstrates clinical value of the Cunningham Panel™ and accuracy in patients with symptoms of an autoimmune encephalopathy
This newly published study examined the correlation in patient pre- and post-treatment symptoms with changes in anti-neuronal autoantibody titers and the neuronal cell stimulation assay in the Cunningham Panel in patients with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS), and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).1
Autoimmune targets in Cunningham Panel™ predict IVIG treatment response in subset of children with autism
This study examines antineuronal antibodies in IVIG responders and supports the classification of a neuroimmune subgroup in patients with ASD. The majority of the ASD patients in this cohort demonstrated elevations in brain-specific autoantibodies measured by the Cunningham Panel™, along with an elevation in the activation of CAMKII. 2
Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia
This article published in the June 2018 issue of Case Reports in Psychiatry involves a complex case of a 15-year-old girl who abruptly developed multiple neurologic and psychiatric symptoms leading to an initial diagnosis of schizophrenia. The authors point out that although the patient’s anti-NMDAR antibody test was negative and MRI’s were normal, the Cunningham Panel™ was positive with all 4 of the ELISA assays elevated and the CaM Kinase II borderline. These results supported the diagnosis of an autoimmune-based neuropsychiatric disorder.3
Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)
Overview of Treatment Guidelines
Part I: Psychiatric and Behavioral Interventions
Part II: Use of Immunomodulatory Therapies
Part III: Treatment and Prevention of Infections
SCHEDULE: IN-SERVICES FOR UTILIZATION OF THE CUNNINGHAM PANEL™
We provide free medical education services to assist clinicians in better understanding the Cunningham Panel™ utilization. This service is available to individual clinicians and group practices.
- Craig Shimasaki, Richard E. Frye, Rosario Trifiletti, Michael Cooperstock, Gary Kaplan, Isaac Melamed, Rosalie Greenberg, Amiram Katz, Eric Fier, David Kem, David Traver, Tania Dempsey, M. Elizabeth Latimer, Amy Cross, Joshua P. Dunn, Rebecca Bentley, Kathy Alvarez, Sean Reim, James Appleman. Evaluation of the Cunningham Panel™ in pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS): Changes in antineuronal antibody titers parallel changes in patient symptoms. Journal of Neuroimmunology, In Press-15 February 2020. Online ahead of print https://www.jni-journal.com/article/S0165-5728(19)30352-2/fulltext
- Drew H. Barzman, Hannah Jackson, Umesh Singh, Marcus Griffey, Michael Sorter, and Jonathan A. Bernstein, “An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment,” Case Reports in Psychiatry, June 28, 2018, Vol. 2018, doi.org/10.1155/2018/8189067
- Connery, K., Tippett, M., Delhey, L.M. et al. Intravenous immunoglobulin for the treatment of autoimmune encephalopathy in children with autism. Transl Psychiatry 8, 148 (2018). https://doi.org/10.1038/s41398-018-0214-7