Autoimmune neuropsychiatric disorders

Swedo, S.E. (1994) Sydenham s chorea. A model for childhood autoimmune neuropsychiatric disorders. JAMA 272 1788-1791. 

Hoffman, K.L. and Lipkin, W.I. (2000) Murine model of autoimmune neuropsychiatric disorders. Abstr Sod Neurosci 26 2310. 

Swedo, S.E., Leonard, H.L., Garvey, M., Mittleman, B., Allen, A.J., Perlmutter, S., Lougee, L., Dow, S., Zamkoff, J., and Dubbert, B.K. (1998) Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections clinical description of the first 50 cases. Am Psychiatry 155 264-271. 

TABLE 14.1 Criteria for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections... 

PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS COMORBIDITIES AND FAMILY FINDINGS... 

B.K. (1998) Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections clinical description of the first 50 cases. Am J Psychiatry 155 264-271. 

Alpha interferons, including peginterferon alfa-2a, may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. 

Alpha interferons, including peginterferon alfa-2b, cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Closely monitor patients with periodic clinical and laboratory evaluations. Withdraw from therapy patients with persistently severe or worsening signs or symptoms of... 

Peg Interferon Alfa 2b (PEG-Intron) [Antiviral/ Immunomodulator] WARNING Can cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disord s. Monitor pts closely Uses Rx Hep C Action Immune modulation Dose 1 mcg/kg/wk SQ 1.5 mcg/kg/wk combined w/ ribavirin Caution [C, X if used w/ ribavirin /-] w/ Hx psychiatric Contra Autoimmune H, decompensated Uvct Dz, hemoglobinopathy Disp Vials 50, 80, 120, 150 mcg/0.5 mL Redipen 50, 80,120,150 mcg/5 mL reconstitute w/ 0.7 mL w/ sterile water SE D ession, insomnia, suicidal behavior, GI upset, neutropenia, thrombocytopenia, alopecia, pruritus Interactions t Myelosuppression W/ antineoplastics t effects OF doxorubicin, theophylline t neurotox W7 vinblastine EMS See Peg Interf on Alfa-2a may cause flu-like Sxs... 

Serious, acute hypersensitivity reactions, such as urticaria, angioedema, broncho-constriction, and anaphylaxis, may occur. Other rare reactions include pancreatitis, colitis, endocrine disorders (e.g., diabetes mellitus), hyperthyroidism or hypothyroidism, ophthalmologic, neuropsychiatric, autoimmune, ischemic, infectious, and pulmonary disorders. 

Recommended dosage and monitoring requirements PEG-Intron is administered once weekly for 1 year. The dose should be administered on the same day of each week. Initial dosing should be based on body weight. Serum hepatitis C virus (HCV) should be assessed after 24 weeks of treatment. Discontinuation of treatment should be considered in patients who have not achieved HCV RNA below the limit of detection after 24 weeks of therapy. Patients should be monitored for neuropsychiatric events, bone marrow toxicity, endocrine disorders, cardiovascular events, colitis, pancreatitis, autoimmune disorders, pulmonary disorders, and hypersensitivity. 

Avoid use in patients with autoimmune disorders. Use caution in patients with neuropsychiatric problems. 

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