Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Cross, Amy; Bouboulis, D.; Shimasaki, Craig; Jones, Cindy

doi:10.3389/fpsyt.2021.505941

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…Positive Lyme disease serology has also been reported in association PANDAS. 50 Moreover, stealth adapted viruses were reliably cultured from children clinically diagnosed as having PANDAS. The generic term "viteria" has been introduced to help convey the concept of stealth adapted viruses being potential carriers of bacteria-derived genetic sequences.…”

Section: Introduction and Discussionmentioning

confidence: 99%

Stealth adapted viruses can incorporate renegade cellular and bacterial genetic sequences: public health implications

Wj¹

2023

JHVRV

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The cellular immune system normally responds to relatively few of the different structural components that comprise the complete virus. Mutation or deletion of the genes coding for these few antigenic components is an immune evasion mechanism termed “stealth adaptation.” I initially used this term to describe a virus derived from an African green monkey simian cytomegalovirus (SCMV). This article provides an extended discussion of the Public Health relevance of previously reported findings relating to this virus. Of particular significance, the virus did not evoke inflammation in the chronic fatigue syndrome (CFS) patient from whom the virus was repeatedly cultured, nor in virus inoculated animals. The viral genome consists of multiple fragments of double stranded DNA with lengths of approximately twenty thousand nucleotides (20 kb). This is in marked contrast to the >226 kb size of the normal SCMV genome. Purified virus DNA was cloned, and sequence data were subsequently obtained. Most of the cloned sequences match to regions corresponding in their entirety to only approximately half of the originating SCMV genome. These matching sequences are very unevenly distributed along the SCMV genome. Moreover, there are significant genetic sequence differences between clones matching to identical regions of the SCMV genome. In addition to the SCMV matching sequences, there are sequences that match to regions of the human genome. There are also sequences that match closely to genes of bacterial origin. The major sources of the bacterial sequences in the initially cultured stealth adapted virus are from Mycoplasma fermentans and Ochrobactrum quorumnocens bacteria. These findings have extended the generic concept of stealth adaptation to include not only the loss or mutation of portions of the originating virus genome, which would have otherwise resulted in cellular immune recognition, but also the potential incorporation/acquisition of additional “renegade” genetic sequences from cellular genes and from other microbial genomes. The apparent acquisition of cellular genetic sequences by stealth adapted viruses may potentially lead to the infectious transmission of genetically determined illnesses. The inclusion of bacterial sequences is also concerning since it indicates possible bacteria mediated transmission of infectious stealth adapted viruses. Furthermore, the transmissible bacterial sequences can potentially result in the mistaken diagnosis of a stealth adapted virus infection for a bacterial disease. Examples are likely to include chronic Lyme disease and PANDAS, a severe childhood psychiatric illness. Public Health officials should respond urgently to the existence of stealth adapted viruses.

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Section: Introduction and Discussionmentioning

confidence: 99%

Stealth adapted viruses can incorporate renegade cellular and bacterial genetic sequences: public health implications

Wj¹

2023

JHVRV

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“…Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series duncani, and responded to broad spectrum antimicrobial therapy [66]. Many of the neuropsychiatric symptoms of neuroborreliosis parallel or overlap with those of PANS, including anxiety disorders, depression, OCD and tics [11][12][13][14][15][16][17]67].…”

Section: Discussionmentioning

confidence: 99%

Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series

Kinderlehrer¹,

Brown²

2021

GJMR

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The incidence of mental health disorders in adolescents continues to rise. The cause of the increase in mental illness is multifactorial, including both environmental and biological causes. To investigate the latter, ten adolescents at a psychiatric residential treatment center in Colorado with the DSM-5 diagnosis of major depressive disorder (MDD), of whom seven were additionally diagnosed with generalized anxiety disorder (GAD), were chosen at random for further serologic study. Testing revealed exposureto group A Streptococcus(GAS) in 2 of 10 (20%); Borrelia Burgdorferi sensulato (Bbsl)in 2 of 10 (20%); and Bartonella speciesin 3 of 10 (30%). In addition, 9 of 10 (90%) subjects had abnormal Cunningham Panels, which measures levels of antineuronal antibodies that have been associated with psychiatric disturbances. Given the degree of psychological dysfunction in these adolescents requiring intensive residential treatment, this case series lends support to the hypothesis that exposure to infectious agents may play a role, perhaps by autoimmune mechanisms, in the significant and ongoing rise in the rate of neuropsychiatric illness in adolescents. This preliminary report adds to this premise and requires further investigation.

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“…Treating children and adolescents with Lyme and other tick-borne diseases is especially complex. Infection-induced autoimmune encephalopathy - a condition in which an infection triggers an autoimmune reaction that targets the brain and leads to changes in neurologic function, mood and behavior - are common (Cross et al, 2021; Jones & Leventhal, 2010). These symptoms might appear suddenly and in turn trigger a change in personality and developmental regression.…”

Section: Symptoms Diagnosis and Treatmentmentioning

confidence: 99%

“…These symptoms often disrupt developmental progress and negatively impact academic performance and social functioning. In addition, tick-borne diseases have been identified in children diagnosed with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome (Cross et al, 2021).…”

Section: Symptoms Diagnosis and Treatmentmentioning

confidence: 99%

Lyme and tick-borne diseases: A primer for mental health practitioners.

Trunzo¹,

Statlender²,

Leventhal³

et al. 2022

Practice Innovations

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Lyme and other tick-borne diseases can cause complex, multisystemic symptoms that pose diagnostic and treatment challenges. This article presents essential information about these infectious diseases and associated medical and neuropsychiatric symptoms. Knowledge of the full range of infection-driven symptoms with these diseases will enable mental health practitioners to (a) avoid misdiagnosis of their patients with a primary psychiatric disorder, (b) facilitate referrals for appropriate medical evaluation and treatment, and (c) help alleviate the suffering caused by these diseases. Clinical Impact StatementLyme disease and other tick-borne diseases can have profound effects on mental health, quality of life, and the general functioning of individuals and family members. This article provides guidance for behavioral health clinicians on treating patients who are suffering from these diseases. It addresses essential issues related to diagnosis, treatment, and the collateral support needs of this complex population.

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Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Cited by 9 publications

References 29 publications

Stealth adapted viruses can incorporate renegade cellular and bacterial genetic sequences: public health implications

Stealth adapted viruses can incorporate renegade cellular and bacterial genetic sequences: public health implications

Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series

Lyme and tick-borne diseases: A primer for mental health practitioners.

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