Autoimmune Neuropsychiatric Disorders Research Articles

Do PANDAS Really Exist

Controversy about the existence of pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infection (PANDAS) is based on

Does Immune-Based Therapy Work for PANDAS?

PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) are characterized by sudden onset of obsessive-compulsive disorder (OCD) symptoms following streptococcal infections in prepubertal children. Similar to other post-streptococcal syndromes (e.g., Syndenham chorea), patients with PANDAS have antibodies that cross-react with basal ganglia. Thus, it was reasonable for investigators to …

Sydenham's chorea: Long-term immunosuppression for psychiatric symptoms

Sydenham's chorea (SC) is, thought to be an autoimmune neuropsychiatric disorder that may have a prolonged fluctuating course. In some children, associated psychiatric symptoms such as depression, anxiety and obsessive-compulsive symptoms are unresponsive to neuroleptic therapy and may cause significant disability. We describe two adolescents with no prior neuropsychiatric disorders who developed SC and psychiatric symptomatology that did not respond to conventional psy- chiatric drugs: a 13-year-old boy with hallucinations and a 14-year-old girl with abulia. They received immunosuppressive therapy for 1 year. Hallucinations in the boy resolved following the yearlong regimen of corticosteroids and did not recur during the 5-year follow-up period. The abulia resolved after 14 weeks of prednisone treatment but recurred several months later; further treatment with prednisone and azathioprine resulted in complete resolution of the abulia over the next year. This report of im- munosuppressive-responsive psychiatric symptoms in SC suggests an underlying autoimmune disorder causing behavioral changes and offers a therapeutic option in neuroleptic resistant cases.

P06.16 Clinical manifestations of the autoimmune process of central nervous system

Background: Pediatric infection triggered Autoimmune Neu¬ropsychiatric Disorders are described in the literature since 1.998. Autoimmune limbic encephalitis is recognized as a precipitating factor of onset temporallobe seizures. Aim: two case reports of children with autoimmune neuropsychiatric disorders. First case: K.L., 13 years old girl was hospitalized for the third cime because she had fever, ataxia, psychomotor seizures, bizarre gait and abnorrnai choreiforrn movements, catatonia, dysarthric speech and communication only in German .anguage with often changes in mood and hallucinations. Previous hospitalization was two weeks earlier because she had a painful right mastoid. First hospitalization was two years earlier because of right mastoids infection and right retrobulbar neuritis. Now the EEG showed the focus of the slow waves on the right temporal, and later on both sides in temporoparietal region ; oligodonal bands in CSF were positive ; MS CT of pyramids showed chronic inflammatory changes right and psychological testing showed deficits in cognitive functions. She was treated with antibiotics, steroids, benzodiazepines and carbamazepine. The patient underwent exploratory antrotomy of the right ear. After that she had started to recover. Second case: In l6-year-old girl non-paraneoplastic lim¬bic encefalitis was diagnosed. Immune thrombocytopenia manifested in chronic form had been diagnosed 11 years earlier. She had complex partial seizures and developed behavioral disturbances: anxiety, feeling of unreality, auditory hallucinations and insomnia. EEG showed frontal fast beta activity. MRI scans demonstrated a temporal swelling. Cere¬brospinal fluid showed pleocytosis and positive oligodonal bands. The serologycal tests for neurotropic viruse were negative. Immunomodulation therapy was followed by an improvement of clinical status.

Progress of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections

儿童链球菌感染相关性自身免疫性神经精神障碍的发病机制.推测为链球菌感染后机体产生的抗链球菌抗体通过分子模拟机制与易感宿主基底神经节上的抗原表位产生交叉反应,从而引起抗神经元抗体介导的运动和行为异常.该病发病突然,常伴强迫症或抽动障碍,治疗上多采用免疫抑制剂和预防性应用抗生素.该文主要讨论该病的特点、发病机制及治疗进展。

Pediatric OCD: Could It Be an Autoimmune Disorder?

Molecular mimicry might figure in both Sydenham chorea (SC) and pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS). According to this hypothesis, antibodies against streptococcal bacteria cross-react with neurons in the basal ganglia. These researchers examined the incidence of such anti–basal ganglia antibodies (ABGA) among 50 children with OCD seen consecutively in …

PANDAS: Is It Really a Beast?

The existence and cause of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) are controversial. In

Strep Causes Neuropsychiatric Disorders in Children

Evidence is mounting that group A β-hemolytic streptococcal (GABHS) infections are associated with pediatric autoimmune neuropsychiatric disorders (PANDAS), such as obsessive-compulsive disorder (OCD) and tics. Although the authenticity of PANDAS continues to be questioned, findings of this prospective study from a pediatric …

Case Study: A New Infection-Triggered, Autoimmune Subtype of Pediatric OCD and Tourette's Syndrome

A review of clinical observations and literature reports leads to the hypothesis that, via a process analogous to Sydenham's chorea, infections with group A beta-hemolytic streptococci, among others, may trigger autoimmune responses that cause or exacerbate some cases of childhood-onset obsessive-compulsive disorder (OCD) or tic disorders (including Tourette's syndrome). If this hypothesis is correct, then immunological treatments should lead to decreased symptoms in some cases. Four cases with abrupt, severe onset or worsening of OCD or tics are presented from an open treatment study. All were boys aged 10 to 14 years. One had OCD, one had Tourette's syndrome, and two had both OCD and Tourette's syndrome. Clinically and on standardized rating scales, their symptoms were in the moderate to very severe range. Two had evidence of recent group A beta-hemolytic streptococci infections, and the others had histories of recent viral illnesses. Two were treated with plasmapheresis, one with intravenous immunoglobulin, and one with immunosuppressive doses of prednisone. All had a clinically significant response immediately after treatment. Diagnostic criteria are provided that describe these cases of pediatric, infection-triggered, autoimmune neuropsychiatric disorders (PITANDs). Suggestions are made regarding the evaluation and management of patients who may have this condition.