“小儿急性发作神经精神综合征”,或PANS,是一种罕见的综合征,其特征是强迫症(OCD)的急性发作,和/或严重限制食物摄入并伴有各种神经精神症状。据我们所知,这是第一例患有COVID-19相关PANS的双胎青少年。十几岁的小双胞胎姐妹,严重限制食物摄入的突然和急性发作,减肥,强迫症,伴有间歇性听觉和视觉幻觉的焦虑,抑郁症,注意力不足,和睡眠障碍,同时伴有轻微的神经系统症状,如手震颤,耳鸣,头晕,头痛,近端肌肉无力,适用于儿童和青少年精神病学诊所。这些神经精神和躯体疾病背后的唯一相关药物是COVID-19,并通过实验室测试进行了验证,如SARS-CoV-2的阳性IgG滴度和其他可能的细菌或病毒因子的阴性生物标志物。在进一步的评估中发现了小脑中的全身性癫痫异常和vermian/folial萎缩。治疗选择包括精神药物,抗生素,抗癫痫药,静脉注射免疫球蛋白可以很好地治疗神经精神症状。临床医生应该考虑SARS-CoV-2作为潜在的病原体,当一个孩子突然发作时,戏剧性的神经精神症状也包括PANS,即使是无症状或有轻微呼吸道症状的患者。
\"Pediatric acute-onset neuropsychiatric syndrome\", or PANS, is a rare syndrome characterized by an acute onset of obsessive-compulsive disorder (OCD), and/or severely restricted food intake accompanied by a variety of neuropsychiatric symptoms. To our knowledge, this is the first
case report of twin adolescents with COVID-19-associated PANS. Dizygotic twin sisters in late teens, with abrupt and acute onset of severely restrictive food intake, weight loss, OCD, anxiety with intermittent auditory and visual hallucinations, depression, attention deficit, and sleep disturbances, simultaneously accompanied by milder neurologic symptoms such as hand tremor, tinnitus, dizziness, headache, and weakness of proximal muscles, were applied to child and adolescent psychiatry clinic. The only relevant agent underlying those neuropsychiatric and somatic complaints was COVID-19, and it was validated with laboratory testing, such as positive IgG titers of SARS-CoV-2 and negative biomarkers for other possible bacterial or viral agents. Generalized epileptic anomaly and a vermian/folial atrophy in the cerebellum were detected in further evaluations. Treatment options consisted of psychotropic agents, antibiotics, antiepileptic, and intravenous immunoglobulin transfusion finely treated the neuropsychiatric symptoms. Clinicians should consider SARS-CoV-2 as a potential agent, when a child presents with abrupt onset, dramatic neuropsychiatric symptoms also consisting of PANS, even in asymptomatic patients or with mild respiratory symptoms.