Relationship between human leukocyte antigen (HLA) alleles and pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS)

WOS: 000458742100007Purpose: The aim of this study is to examine the relationship between Pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS) and Human Leukocyte Antigen (HLA) alleles. Materials and Methods: HLA alleles of 41 children patients, whom are diagnosed with rapid onset of obsessive compulsive disorder (OCD), and 88 healthy children are analyzed by using PCR. Results are evaluated by using univariate and multivariate logistic regression analysis. Results: DRB8, DRB5.2 and DQ5 alleles increase risk of disease while Al, B18 and B35 alleles decrease risk of disease. Conclusion: Findings of this study will help researchers to examine related genes in PANDAS and the effects of gene products on development of the disease. Presentation of exogenic antigens to T-helper cells by HLA class II loci is determined in different autoimmune diseases. Similarity of these findings with PANDAS etiology and risk increasing alleles found in this study being HLA class II is remarkable

Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study

Background: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. Results: The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. Conclusions: In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. Impact: MIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality