An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment

The patient in this study was initially diagnosed with schizophrenia but did not respond to standard treatment.

The patient’s history was described as follows: “Over the course of one year at age 15, she required four inpatient psychiatric hospitalizations and numerous outpatient and medication management appointments due to an acute onset of “seizure-like” spells, psychotic thinking, and seemingly schizophrenic symptoms, manifesting as auditory hallucinations (AH) and catatonic movements.” ¹

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 and directed the physican to a course of treatment that resulted in complete resolution of her symptoms.

Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

The author’s stated that, “After one course of plasmapheresis was administered (seven treatments every other day), the patient had complete resolution of her psychotic, OCD, and anxiety symptoms. She was able to be weaned off olanzapine and resume many of her normal activities including tennis, within 2 weeks after plasmapheresis.”

“This case illustrates the importance of establishing a broad differential diagnosis including underlying autoimmune encephalopathy, PANDAS/PANS, infection, and other immunologic disorders when evaluating patients presenting with OCD with rituals, severe anxiety, and psychotic symptoms.”