Maternal history of autoimmune disease in children presenting with tics and/or obsessive-compulsive disorder
T K Murphy1, E A Storch, A Turner
1Department of Pediatrics, University of South Florida, College of Medicine, St. Petersburg, FL 33701, USA. tmurphy@health.usf.edu
Insights
Maternal autoimmune disease is more common in mothers of children with obsessive-compulsive disorder (OCD) or tics, particularly those meeting Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) criteria.
Area of Science:
- Neuroscience
- Immunology
- Pediatrics
Background:
- Pediatric neuropsychiatric disorders often show familial autoimmune disease links, especially maternal.
- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) involves CNS autoimmunity post-streptococcal infection.
Purpose of the Study:
- To investigate increased maternal autoimmune risk in children with OCD and/or tics.
- To determine if maternal autoimmune disease prevalence is higher in PANDAS cases.
Main Methods:
- Structured interviews assessed the medical history of biological mothers of 107 children with OCD/tics.
- Comparison of autoimmune disease prevalence between mothers of likely PANDAS and unlikely PANDAS cases.
Main Results:
- Autoimmune disorders were reported in 17.8% of mothers, significantly higher than the US general prevalence (approx. 5%).
- Mothers of children meeting PANDAS criteria showed a higher likelihood of autoimmune disease.
Conclusions:
- Preliminary findings support links between maternal autoimmune disease and pediatric OCD/tics, including PANDAS.
- Further research is needed to explore specific autoimmune links and familial relevance.
Objectives:
A commonality across a number of pediatric neuropsychiatric disorders is a higher than typical rate of familial - and especially maternal - autoimmune disease. Of recent interest, a subtype of obsessive-compulsive disorder (OCD) and tic disorders known collectively as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) is believed to be secondary to central nervous system (CNS) autoimmunity that occurs in relation to group A streptococcal infection. Thus, we hypothesized that a sample of children with OCD and/or tics would have an increased maternal risk for an autoimmune response relative to population norms. We also expected maternal prevalence of various autoimmune diseases to be higher among those participants that met the putative criteria for PANDAS.
Methods:
We examined, via structured interview, the medical history of the biological mothers of 107 children with OCD and/or tics.
Results:
Autoimmune disorders were reported in 17.8% of study mothers, which is significantly greater than the general prevalence among women in the United States (approximately 5%). Further, study mothers were more likely to report having an autoimmune disease if their children were considered "likely PANDAS" cases versus "unlikely PANDAS" cases.
Conclusions:
The results offer preliminary support for hypothesized links between maternal autoimmune disease and both OCD/tics and PANDAS in youth. Further research is necessary to clarify these general associations; links to specific autoimmune disease; and relevance of autoimmune disease in other family members (e.g., fathers).
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