February 25, 2020

New Multidisciplinary Clinic Addresses Rare Disorders

Veerapandiyan

Aravindhan Veerapandiyan, M.D.

Raney

Veronica Raney, M.D.

Since the last legislative session in early 2019, the Psychiatric Research Institute has helped lead the development of an exciting new specialty clinic for children and adolescents that has started at Arkansas Children’s Hospital (ACH) in conjunction with the UAMS Department of Pediatrics. The clinic is a multi-disciplinary clinic for children and adolescents suffering or suspected of suffering from a group of disorders known as Childhood Post-infectious Autoimmune Encephalopathy. These illnesses, which are relatively rare, are sometimes known by the acronyms PANS or PANDAS.

In these diseases, a child develops autoimmune antibodies to certain regions of the brain following a bacterial infection such as a strep throat. The onset of the psychiatric symptoms, which are almost always anxiety related such as obsessive/compulsive behaviors, phobias, and refusal to complete certain acts such as eating a meal, have a remarkable sudden onset and can become severe in a very short period of time. Fortunately, these illnesses are relatively rare; the true incidence is unknown as the diseases were only identified in the 1990s. However, the child becomes very ill, the families become understandably frantic, and the psychiatric after effect can be lifelong. Prompt diagnosis and treatment is essential to a good outcome.

The diagnosis is complex to make and requires multiple disciplines, including child psychiatry, pediatric neurology, developmental pediatrics, and pediatric immunology. The ACH clinic is led by co-medical directors Drs. Veronica Raney, M.D. (Child Psychiatry) and Aravindhan Veerapandiyan, M.D., (Pediatric Neurology).

Our clinic is a part of the PACE Foundation consortium joining the University of Arizona, UCLA, Stanford, and the University of Wisconsin. Our ACH clinic will be the fifth in the country to open. Likely, three more clinics from the East Coast will follow, and then the option of joining the consortium will close. Thus, our clinic is expected to have a multi-state draw and, perhaps, some international patients. The PACE Foundation will foster collaborative research, outreach to child healthcare providers and evidenced-based treatment.

State Sen. Kim Hammer and state Rep. Les Warren have been very strong advocates for this clinic. Through their advocacy, Gov. Asa Hutchinson has released some of his Rainy Day Fund to support the clinic’s initial operation and outreach.

The clinic had a soft opening in November. The first patient was from Northwest Arkansas. His pediatrician suspected CPAE, initiated treatment, and referred the patient to the clinic. At the clinic, the diagnosis was confirmed and longer-term treatment began. He will be followed at the clinic in addition to his pediatrician. His condition has improved dramatically.