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Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)
Dalia Dop1, Iulia Rahela Marcu2, Rodica Padureanu3
1Department of Pediatrics, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania.
Insights
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) link sudden behavioral changes in children to strep infections. Early diagnosis and treatment are crucial to prevent long-term symptoms like tics and OCD.
Area of Science:
- Pediatric autoimmune neuropsychiatric disorders
- Infectious disease immunology
- Neuropsychiatry
Background:
- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) involve sudden-onset OCD, tics, and behavioral symptoms in children following streptococcal infections.
- PANDAS are considered autoimmune due to demonstrable infection and host response, with molecular mimicry as a frequent pathogenic mechanism.
- Molecular mimicry involves foreign antigens sharing similarities with self-antigens, triggering autoimmune reactions.
Purpose of the Study:
- To review the immunological, clinical, and microbiological aspects of PANDAS.
- To explore current treatment strategies for PANDAS.
- To highlight the importance of recognizing and treating PANDAS to prevent adult-onset symptoms.
Main Methods:
- A comprehensive literature review was conducted.
- Searches were performed using PubMed and SCOPUS databases.
- The review focused on immunological, clinical, microbiological, and treatment-related aspects of PANDAS.
Main Results:
- Diagnosis of PANDAS is primarily clinical, requiring detailed medical history and physical examination.
- Treatment for PANDAS is complex and multifaceted.
- Untreated PANDAS can lead to persistent obsessive-compulsive symptoms and tics in adulthood.
Conclusions:
- Further research is necessary to establish optimal therapeutic approaches for PANDAS.
- Early identification and intervention are critical for managing PANDAS.
- Understanding the autoimmune basis of PANDAS is key to developing effective treatments.
Abstract:
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are clinically characterized by the sudden onset of obsessive-compulsive manifestations, motor and verbal tics, as well as other behavioral symptoms in a group of children with B-hemolytic streptococcal infection. PANDAS are considered autoimmune diseases because the streptococcal infection and response can be demonstrated. The most frequent physiopathological mechanism is molecular mimicry: A foreign antigen shares sequence or structural similarities with self-antigens. A thorough review of the literature was carried out using the PubMed database and SCOPUS, searching for immunological, clinical and microbiological aspects, as well as the treatment of the PANDAS syndrome. The diagnosis is clinical and it requires a careful medical history and a thorough physical examination, while the treatment is complex. Untreated or unrecognized manifestations of PANDAS can increase the risk of obsessive-compulsive manifestations and tics during adulthood. Taking this into consideration, further studies are required to establish the best method of therapy.
