Publication
Case Report: Varicella Associated Neuropsychiatric Syndrome (VANS) in Two Pediatric Cases
| dc.contributor.author | Dahiya, D | |
| dc.contributor.author | Matos, CM | |
| dc.contributor.author | Lim, M | |
| dc.contributor.author | Madureira, I | |
| dc.contributor.author | Duarte, S | |
| dc.contributor.author | Byrne, S | |
| dc.contributor.author | Rossor, T | |
| dc.date.accessioned | 2023-03-22T09:32:13Z | |
| dc.date.available | 2023-03-22T09:32:13Z | |
| dc.date.issued | 2023 | |
| dc.description.abstract | Background: Viral or bacterial infections can trigger auto-immune inflammatory reactions and conditions in children. Self-reactivity arises due to similarities in molecular structures between pathogenic microorganisms and regular body structures with consequent immune-cross reactions. Reactivation of latent Varicella Zoster Virus (VZV) infections can cause neurological sequalae, including cerebellitis, post-herpetic neuralgias, meningo/encephalitis, vasculopathy and myelopathy. We propose a syndrome caused by auto-immune reactivity triggered by molecular mimicry between VZV and the brain, culminating in a post-infectious psychiatric syndrome with childhood VZV infections. Case presentation: Two individuals, a 6-year-old male and 10-year-old female developed a neuro-psychiatric syndrome 3-6 weeks following a confirmed VZV infection with intrathecal oligoclonal bands. The 6-year-old male presented with a myasthenic syndrome, behavior deterioration and regression in school, he was poorly responsive to IVIG and risperidone, however had a pronounced response to steroid treatment. The 10-year-old female presented with marked insomnia, agitation, and behavioral regression as well as mild bradykinesia. A trial of neuroleptics and sedatives resulted in a mild unsustained reduction in psychomotor agitation and IVIG was also unsuccessful, however the patient was very responsive to steroid therapy. Conclusion: Psychiatric syndromes with evidence of intrathecal inflammation temporally related to VZV infections that are responsive to immune modulation have not been described before. Here we report two cases demonstrating neuro-psychiatric symptoms following VZV infection, with evidence of persistent CNS inflammation following the resolution of infection, and response to immune modulation. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Brain Behav Immun Health . 2023 Feb 11;28:100602 | pt_PT |
| dc.identifier.doi | 10.1016/j.bbih.2023.100602 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4469 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.subject | Attention Deficit Hyperactivity Disorder | pt_PT |
| dc.subject | Central Nervous System | pt_PT |
| dc.subject | Auto-immune encephalitis | pt_PT |
| dc.subject | Cerebral Spinal Fluid | pt_PT |
| dc.subject | Intravenous Immunoglobulin | pt_PT |
| dc.subject | Cross reactivity | pt_PT |
| dc.subject | N-methyl-D-aspartate | pt_PT |
| dc.subject | Varicella Zoster Virus | pt_PT |
| dc.subject | Child | pt_PT |
| dc.subject | HDE REUM PED | pt_PT |
| dc.title | Case Report: Varicella Associated Neuropsychiatric Syndrome (VANS) in Two Pediatric Cases | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.startPage | 100602 | pt_PT |
| oaire.citation.title | Brain, Behavior, & Immunity - Health | pt_PT |
| oaire.citation.volume | 28 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |