Evaluation of the Cunningham Panel™ in pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS): Changes in antineuronal antibody titers parallel changes in patient symptoms

Background. Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS) is the acute onset of neuropsychiatric symptoms following group A beta-haemolytic streptococcal infection. The aetiology remains elusive. However, with group A streptococcus being the most common bacterial cause of tonsillitis, surgical intervention in the form of tonsillectomy has often been considered as a potential therapy. Methods. A MEDLINE® search was undertaken using keywords “PANDAS” or “paediatric autoimmune neuropsychiatric disorders associated with streptococcus” combined with “tonsillectomy”. Results. Six case reports and 3 case series met the inclusion criteria. Demesh et al. (case series) reported a dramatic reduction in neuropsychiatric symptom severity in the patient cohort undergoing tonsillectomy. Two case series suggest that there is no association between tonsillectomy and resolution of PANDAS. Conclusion. Due to the lack of uniform data and sporadic reports, tonsillectomy should be carefully adopted for the treatment of this disorder. In particular, tonsillectomies/adenoidectomies to alleviate neuropsychiatric symptoms should be avoided until more definitive evidence is at our disposal. This review highlights the importance of a potential collaborative prospective study.

Download Full-text

A Complex Case of Anorexia Nervosa Associated with Pediatric Acute-Onset Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS)

Complex Clinical Conundrums in Psychiatry ◽

10.1007/978-3-319-70311-4_21 ◽

2018 ◽

pp. 219-222

Author(s):

Peter Ajueze ◽

Kuppuswami Shivakumar ◽

Kevin Saroka

Keyword(s):

Anorexia Nervosa ◽

Streptococcal Infection ◽

Acute Onset ◽

Neuropsychiatric Disorder ◽

Complex Case

Download Full-text

Treatment of Pediatric Acute-Onset Neuropsychiatric Disorder in a Large Survey Population

Journal of Child and Adolescent Psychopharmacology ◽

10.1089/cap.2017.0101 ◽

2018 ◽

Vol 28 (2) ◽

pp. 92-103 ◽

Cited By ~ 7

Author(s):

Denise Calaprice ◽

Janice Tona ◽

Tanya K. Murphy

Keyword(s):

Acute Onset ◽

Neuropsychiatric Disorder ◽

Survey Population ◽

Large Survey

Download Full-text

STREPTOCOCCAL ANTIBODY TITERS IN SYDENHAM'S CHOREA

PEDIATRICS ◽

10.1542/peds.38.6.946 ◽

1966 ◽

Vol 38 (6) ◽

pp. 946-956 ◽

Cited By ~ 1

Author(s):

Elia M. Ayoub ◽

Lewis W. Wannamaker

Keyword(s):

Streptococcal Infection ◽

Potential Usefulness ◽

Nicotinamide Adenine ◽

Control Group ◽

Significant Percentage ◽

Matched Group ◽

Sydenham’S Chorea ◽

Antibody Titers ◽

Sydenham's Chorea ◽

Antibody Tests

Antistreptolysin O (ASO), anti-desoxyribonuclease B (anti-DNAse B), and anti-nicotinamide adenine dinucleotidase (anti-NADase) titers were determined on patients with Sydenham's chorea and a matched group of controls. For each of the antibodies studied, elevated titers were found in a significant percentage of patients with chorea as compared with control individuals. This finding was also true of patients with "pure chorea" on whom antibody titers were performed within 6 months of the onset of choreic symptoms. Ten of 30 such patients failed to show an elevated ASO titer. Four of these were found to have markedly elevated anti-DNAse B titers. Elevation of two or more antibody tests, which is highly suggestive of recent streptococcal infection, was found in the majority (63%) of patients with pure chorea seen within 6 months as compared with the control group (10%). The practical and potential usefulness of multiple streptococcal antibody tests in patients with pure Sydenham's chorea is discussed.

Download Full-text