PANS – Pediatric Acute-onset Neuropsychiatric Syndrome is a syndrome that is also characterized by neuropsychiatric disorders in children, but in this case, there are later identified causes that are not usually related specifically to streptococcus but can include more than 200 different factors, including other bacteria, viruses or even tumors.
The Cunningham panel includes such highly accurate immunological laboratory tests:
- Autoantibodies (AATs) against dopamine D1 and D2 receptors;
- AAT against lysoganglioside-GM1;
- AAT vs. tubulin;
- analysis of calcium/calmodulin-dependent protein kinase II (CaMKII) activity.
Elevated antibody levels in one or more of these tests indicate that neuropsychiatric symptoms may be associated with a treatable autoimmune disorder (potentially caused by an infection rather than a classic neurological or psychiatric illness).
Understanding which of the above regulators AATs are formed and the activity of CaMKII is the basis for choosing the optimal course of treatment, which must be tailored individually and may differ in both duration and cost, which is very important for each patient to understand.
It is important to remember that Cunningham tests cannot be taken earlier than 3 months after the end of immunoglobulin therapy.
Dopamine receptors (D1, D2, D3, D4, D5) are widely distributed in the brain and mediate the effects of dopamine on cognition, emotion, regulation of hunger, satiety, motor activity, and the endocrine system. When a patient's autoantibodies are directed against the D1 and D2 dopamine receptors, they can disrupt the normal function of these receptors. This can be either stimulation of the receptors or blockage of the ability of dopamine to bind to them, leading to the manifestation of various neuropsychiatric disorders. People with elevated levels of antibodies to dopamine receptors often have neurological disorders: psychosis, obsessive-compulsive disorder, and tics (uncontrolled motor movements), hyperactivity, and impulsivity.
