Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome
Authors' conclusion
This study found that patients with PANS show signs of immune activation and vasculopathy during psychiatric symptom flares and have an increased risk of developing arthritis and other autoimmune diseases compared with the general pediatric population. The most common arthritis subtype was enthesitis-related arthritis.
Study context
- Population
- Consecutive children with PANS followed up within the Stanford Immune Behavioral Health Clinic, September 1, 2012, to December 31, 2021112 boys [58.0%]
- Participants
- 193 children
- Outcome
- Immune activation and vasculopathy markers during a flare; cumulative risk of arthritis and other autoimmune diseases
Methodological detailsconsecutive patients, single clinic, Kaplan-Meier survival probability
- Consecutive patients
- Single clinic
- Kaplan-Meier survival probability
Main finding
As reported in the abstract
- Nonspecific markers of autoimmunity (97 of 179 tested)
- 54.2%
- Nonspecific signs of immune dysregulation or inflammation (22 of 184 tested)
- 12.0%
- Signs of vasculopathy (69 of 193)
- 35.8%
- Estimated cumulative incidence of arthritis by 14 years of age
- 28.3% (95% CI, 20.8%-36.3%)
- Estimated cumulative incidence of another autoimmune disease by 14 years of age
- 7.5% (95% CI, 4.0%-12.4%)
Observational data: associations, not effects.
Further findings
Clinical findings in subgroup with arthritis
- Joint capsule thickening (22 of 40)
- 55.0%
- Distal interphalangeal joint tenderness (45 of 55)
- 81.8%
- Spinous process tenderness (44 of 55)
- 80.0%
Arthritis subtypes among the 55 patients with arthritis
- Enthesitis-related arthritis (37)
- 67.3%
- SpA (27)
- 49.1%
- PsA (10)
- 18.2%
Original publication
Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome. JAMA Netw Open. Published 1 July 2024. doi:10.
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