Pervasive refusal syndrome.

Area of Science:

• Pediatric Neurology
• Psychiatry
• Immunology

Background:

• Pervasive Refusal Syndrome (PRS) is a rare condition, typically affecting adolescent girls.
• Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) can precede PRS development.
• The etiology of PRS remains incompletely understood, with potential infectious or autoimmune links.

Observation:

• A 14-year-old boy presented with severe PRS symptoms, including mutism, immobility, tics, sensory hypersensitivity (hyperacusis, hyperesthesia), and selective feeding difficulties.
• The patient's condition evolved from a prior diagnosis of CFS/ME.
• Initial serological investigations indicated a possible preceding infection and potential autoimmune markers.

Findings:

• Successful home-based treatment and rehabilitation were achieved for the adolescent boy.
• The case highlights PRS occurring in an adolescent male, contrasting with the typical demographic.
• Serological findings suggest a potential infective trigger and autoimmune involvement in PRS.

Implications:

• This case expands the known demographic of Pervasive Refusal Syndrome.
• The findings support exploring infectious and autoimmune pathways in PRS.
• Revisiting the nomenclature of Pervasive Refusal Syndrome may improve clinical understanding and therapeutic alliances.