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The Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection (PANDAS) Etiology for Tics and Obsessive-Compulsive Symptoms: Hypothesis or Entity? Practical Considerations for the Clinician
Abstract
Clinicians have been faced with much publicity and contradictory scientific evidence regarding a recently described condition termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). It has been proposed that children with PANDAS experience tics, obsessive-compulsive behavior, and perhaps other neuropsychiatric symptoms as an autoimmune response to streptococcal infection. We review current scientific information and conclude that PANDAS remains a yet-unproven hypothesis. Until more definitive scientific proof is forthcoming, there seems to be insufficient evidence to support 1) routine microbiologic or serologic testing for group A streptococcus in children who present with neuropsychiatric symptoms or 2) the clinical use of antibiotic or immune-modifying therapies in such patients. The optimum diagnostic and therapeutic approach awaits the results of additional research studies.
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Cited by
Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus
Walker, M. J., Barnett, T. C., McArthur, J. D., Cole, J. N., Gillen, C. M., Henningham, A., Sriprakash, K. S., Sanderson-Smith, M. L., & Nizet, V. (2014) · Clinical Microbiology Reviews · doi:10.1128/cmr.00101-13 · Cited by 908
The neural bases of obsessive-compulsive disorder in children and adults
Maia, T. V., Cooney, R. E., & Peterson, B. S. (2008) · Development and Psychopathology · doi:10.1017/s0954579408000606 · Cited by 362
“Second, the validity of the PANDAS construct remains controversial (Harris & Singer, 2006; Kurlan, 2004; Kurlan & Kaplan, 2004; Singer & Loiselle, 2003), with substantial difficulties involved in establishing a causal relation between infection with Group A betahemolytic streptococcus and the…”
BackgroundNeurobiology of Tourette Syndrome: Current Status and Need for Further Investigation: Table 1.
Felling, R. J., & Singer, H. S. (2011) · The Journal of Neuroscience · doi:10.1523/jneurosci.0150-11.2011 · Cited by 227
Swedo, S. E., Leonard, H. L., & Rapoport, J. L. (2004) · Pediatrics · doi:10.1542/peds.113.4.907 · Cited by 221
Metadata
- Authors
- Kurlan, R., & Kaplan, E. L.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2004-04-01
- Volume
- 113
- Issue
- 4
- Pages
- 883-886
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2038448100
- Cited by
- 161
- References
- 4
- FWCI
- 15.74
- Type
- journal article
- Language
- en
- Open access
- closed
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