Large-scale Analysis Reveals Subtle Systemic Inflammation Linked to Early Signs of Psoriatic Arthritis and Spondyloarthritis, Emphasizing the Need for Early Detection and Treatment
A new original investigation featured in JAMA Network has provided the largest longitudinal analysis of pediatric acute-onset neuropsychiatric syndrome (PANS) to date, revealing a high incidence of immune activation, arthritis, and autoimmune diseases among patients. These findings suggest that PANS may be linked to an inflammatory condition similar to neuropsychiatric lupus, with symptoms such as capsulitis and nail pitting potentially indicating early signs of psoriatic arthritis (PsA) or spondyloarthritis (SpA). Notably, markers of systemic inflammation, such as elevated von Willebrand factor and D-dimer levels, were observed in subjects despite the lack of overt infections, and high antihistone antibody levels were found, though not universally across cohorts. This study highlights that subtle systemic inflammation in PANS might be crucial for early arthritis detection and treatment, underscoring the need for further research into how anti-inflammatory treatments could mitigate both psychiatric and inflammatory symptoms in these patients.
