A5002367577- Systemic Lupus Erythematosus Research
- Autoimmune Neurological Disorders and Treatments
- Autoimmune and Inflammatory Disorders Research
- Peripheral Neuropathies and Disorders
- Kawasaki Disease and Coronary Complications
- Adolescent and Pediatric Healthcare
- Genetics and Neurodevelopmental Disorders
- Epilepsy research and treatment
- Renal Diseases and Glomerulopathies
- Inflammasome and immune disorders
- Pharmacological Effects and Toxicity Studies
- Infectious Encephalopathies and Encephalitis
- Platelet Disorders and Treatments
- Vasculitis and related conditions
- Monoclonal and Polyclonal Antibodies Research
- Diversity and Career in Medicine
- Complement system in diseases
- Immunodeficiency and Autoimmune Disorders
- Cytomegalovirus and herpesvirus research
- Neurological Complications and Syndromes
- Bacterial Infections and Vaccines
- Neuroscience and Neuropharmacology Research
- Herpesvirus Infections and Treatments
- Neurological and metabolic disorders
- Streptococcal Infections and Treatments
Texas Children's Hospital
2016-2025
Baylor College of Medicine
2016-2025
Baylor School
2021-2025
Center for Rheumatology
2020-2024
Duke University
2024
Norwegian Womens Public Health Association
2023
University of Alabama at Birmingham
2022
KK Women's and Children's Hospital
2021
University of California, San Francisco
2021
Amgen (United States)
2021
<h3>Objective:</h3> To assess the utility and safety of rituximab in pediatric autoimmune inflammatory disorders CNS. <h3>Methods:</h3> Multicenter retrospective study. <h3>Results:</h3> A total 144 children adolescents (median age 8 years, range 0.7–17; 103 female) with NMDA receptor (NMDAR) encephalitis (n = 39), opsoclonus myoclonus ataxia syndrome 32), neuromyelitis optica spectrum 20), neuropsychiatric systemic lupus erythematosus 18), other neuroinflammatory 35) were studied. Rituximab...
<h3>Objective</h3> Autoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. Diagnosis AE in a developing child challenging because overlap clinical presentations with other diseases complexity normal behavior changes. Existing diagnostic criteria for adult require modification to be applied children, who differ from adults their presentations, paraclinical findings, autoantibody profiles, treatment response, long-term outcomes. <h3>Methods</h3> A subcommittee...
To create an international consensus treatment recommendation for pediatric NMDA receptor antibody encephalitis (NMDARE).After selection of a panel 27 experts with representation from all continents, 2-step Delphi method was adopted to develop on relevant regimens and statements, along key definitions in NMDARE (disease severity, failure improve, relapse). Finally, online face-to-face meeting held reach (defined as ≥75% agreement).Corticosteroids are recommended children (pulsed IV...
Abstract Several pieces of evidence suggest immune dysregulation could trigger the onset and modulate sequelae new refractory status epilepticus (NORSE), including its subtype with prior fever known as febrile infection‐related epilepsy syndrome (FIRES). Consensus‐driven recommendations have been established to guide initiation first‐ second‐line immunotherapies in these patients. Here, we review literature date on immunotherapy for NORSE/FIRES, presenting results from 28 case reports series...
ABSTRACT Febrile infection related epilepsy syndrome (FIRES) is a rare presentation of refractory status epilepticus with immune dysregulation as potential pathologic mechanism. Despite promising results from second‐line immunomodulators, approximately 30% remain to treatment. We describe two children FIRES who were unable wean anesthetic infusions immunomodulatory treatment and subsequently received concurrent intrathecal dexamethasone anakinra/tocilizumab escalation therapy. Following the...
To formulate consensus treatment plans (CTPs) for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in juvenile systemic erythematosus (SLE).A structured formation process was employed by the members Childhood Arthritis and Rheumatology Research Alliance after considering existing medical evidence current approaches.After an initial Delphi survey (response rate = 70%), a 2-day conference, 2 followup surveys rates 63-79%), achieved limited set CTPs addressing LN. These...
Abstract Objective To compare the criteria for Wegener's granulomatosis (WG) of American College Rheumatology (ACR) with those European League Against Rheumatism/Pediatric Society (EULAR/PRES) in a cohort children WG and other antineutrophil cytoplasmic antibody (ANCA)–associated vasculitides (AAVs), to describe interval diagnosis, presenting features, initial treatment WG. Methods Eligible patients had been diagnosed by site rheumatologists (termed “MD diagnosis”) since 2004. This diagnosis...
ABSTRACT Background Movement disorders are frequent but difficult to characterize in patients with anti‐ N ‐methyl‐ d ‐aspartate receptor ( NMDAR ) encephalitis. Methods The phenomenology of movement was characterized after a detailed examination children ‐encephalitis. Results We studied 9 (5 females), ages 3–14 years, confirmed All presented at least 1 disorder, including chorea (n=4), stereotypic movements ataxia (n=3), limb dystonia (n=2), myorhythmia oromandibular facial myorhythmia,...
Objective To uniquely classify children with microscopic polyangiitis (MPA), to describe their demographic characteristics, presenting clinical features, and initial treatments in comparison patients granulomatosis (Wegener's) (GPA). Methods The European Medicines Agency (EMA) classification algorithm was applied by computation categorical data from recruited the ARChiVe (A Registry for Childhood Vasculitis: e‐entry) cohort, censored November 2015. EMA used distinguish MPA GPA, whose...
The natural history of NMDA receptor (NMDAR) antibody encephalitis in adults and children is altered by treatment with immunosuppressive therapy or tumor removal.1 In adult cohorts, early initiation immunotherapy appears to be beneficial.1,2 the largest series date, Titulaer et al.1 demonstrated that earlier was associated a modified Rankin Scale (mRS) score 2 less cohort 501 (univariate analysis p = 0.009, multivariable < 0.0001). Multivariable on 177 within showed an mRS less, although...
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a clinically heterogeneous disorder with number of different etiologies and disease mechanisms. Inflammatory postinfectious autoimmune presentations PANS occur frequently, some clinical series documenting immune abnormalities in 75%-80% patients. Thus, comprehensive treatment protocols must include immunological interventions, but their use should be reserved only for cases which the symptoms represent underlying neuroinflammation or...
Abstract Febrile‐infection related epilepsy syndrome (FIRES) is a devastating neurological condition characterized by febrile illness preceding new onset refractory status epilepticus (NORSE). Increasing evidence suggests innate immune dysfunction as potential pathological mechanism. We report an international retrospective cohort of 25 children treated with anakinra, recombinant interleukin‐1 receptor antagonist, immunomodulator for FIRES. Anakinra was potentially safe only one child...
IMPORTANCE Rituximab is among the most frequently used immunotherapies in pediatrics.Few studies have reported long-term adverse events associated with its use for children.OBJECTIVE To describe of rituximab and to assess whether shortor events, infections, or time immune reconstitution a diverse group young people. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included 468 patients aged younger than 21 years who received indications between October 1, 2010, December 31,...
BACKGROUND AND OBJECTIVES: Encephalitis can result in neurologic morbidity and mortality children. Newly recognized infectious noninfectious causes of encephalitis have become increasingly important over the past decade. METHODS: We retrospectively reviewed medical records from pediatric patients Houston diagnosed with both an urban rural catchment area between 2010 2017. conducted investigation to understand etiology, clinical characteristics, diagnostic testing practices this population....
Febrile infection-related epilepsy syndrome (FIRES) is a rare catastrophic epileptic encephalopathy that presents suddenly in otherwise normal children and young adults causing significant neurological disability, chronic epilepsy, high rates of mortality. To suggest therapy protocol to improve outcome FIRES, workshops were held conjunction with American Epilepsy Society annual meeting between 2017 2019. An international group pediatric epileptologists, neurointensivists, rheumatologists...
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by pathologic immune activation in which prompt recognition and initiation of suppression essential for survival. Children with HLH have many overlapping clinical features critically ill children sepsis systemic inflammatory response (SIRS) whom alternative therapies are indicated. To determine whether plasma biomarkers could differentiate from other conditions to better define core signature HLH, concentrations proteins...
Background Febrile-infection related epilepsy syndrome (FIRES) is a rare in which previously healthy individual develops refractory status epilepticus the setting of preceding febrile illness. There are limited data regarding detailed long-term outcomes. This study aims to describe neuropsychological outcomes series pediatric patients with FIRES. Methods retrospective multi-center case diagnosis FIRES treated acutely anakinra who had testing at least 12 months after onset. Each patient...
This report discusses the difference between antiphospholipid antibodies (aPL) as a predictor for first and recurrent ischemic stroke, whether or not concomitant systemic lupus erythematosus (SLE) increases aPL-associated risk, association of aPL with other neurological manifestations. The manifestations covered in this were selected because they are among most common, including cognitive dysfunction, headache, multiple sclerosis seizures/epilepsy. Recommendations made regarding further...