Patient Satisfaction and Treatments Offered to Swedish Patients with Suspected Pediatric Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are clinical conditions characterized by the sudden onset of obsessive–compulsive disorder and/or tics, often accompanied by other behavioral symptoms in a group of children with streptococcal infection. PANDAS-related disorders, including pediatric acute-onset neuropsychiatric syndrome (PANS), childhood acute neuropsychiatric symptoms (CANS), and pediatric infection triggered autoimmune neuropsychiatric disorders (PITANDs), have also been described. Since first defined in 1998, PANDAS has been considered a controversial diagnosis. A comprehensive review of the literature was performed on PubMed and Scopus databases, searching for diagnostic criteria and diagnostic procedures of PANDAS and related disorders. We propose a test panel to support clinicians in the workout of PANDAS/PANS patients establishing an appropriate treatment. However, further studies are needed to improve our knowledge on these acute-onset neuropsychiatric conditions.

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Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

10.21203/rs.2.19372/v5 ◽

2020 ◽

Author(s):

Lorenzo Loffredo ◽

Alberto Spalice ◽

Francesca Salvatori ◽

De Castro Giovanna ◽

Cristiana Alessia Guido ◽

...

Keyword(s):

Linear Regression Analysis ◽

Prostaglandin F2α ◽

Neuropsychiatric Disorders ◽

Serum Levels ◽

Multiple Linear Regression Analysis ◽

Acute Onset ◽

Tic Disorders ◽

Bivariate Analysis ◽

Streptococcal Infections ◽

Obsessive Compulsive

Abstract Background: paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (8-iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods: in this study we wanted to compare serum levels of soluble NOX2-dp (sNOX-2-dp), iso-PGF2α and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay.Results: compared with CT, PANDAS children had increased serum levels of sNOX-2-dp, 8-iso-PGF2α and LPS. Bivariate analysis showed that serum sNOX2-dp was signiﬁcantly correlated with LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and 8-iso-PGF2α (Rs=0.704; p<0.001). Serum LPS signiﬁcantly correlated with zonulin (Rs=0.610; p<0.001), and 8-iso-PGF2α (Rs=0.591; p=0.001). Finally, a multiple linear regression analysis showed that serum 8-iso-PGF2α and zonulin were the only independent variables associated with sNOX2-dp (R2=68%).Conclusion: this study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be involved in the process of neuroinflammation.

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Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections/pediatric acute-onset neuropsychiatric syndromes vs. pediatric bipolar disorder—A possible connection?

Neurology Psychiatry and Brain Research ◽

10.1016/j.npbr.2014.06.004 ◽

2014 ◽

Vol 20 (3) ◽

pp. 49-54 ◽

Cited By ~ 4

Author(s):

Rosalie Greenberg

Keyword(s):

Bipolar Disorder ◽

Neuropsychiatric Disorders ◽

Acute Onset ◽

Pediatric Bipolar Disorder ◽

Streptococcal Infections

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Pediatric Acute-Onset Neuropsychiatric Syndrome

10.1093/med-psych/9780190052775.003.0013 ◽

2021 ◽

pp. 231-248

Author(s):

Kirti Saxena ◽

Sherin Kurian ◽

Johanna Saxena ◽

Eyal Muscal

Keyword(s):

Clinical Features ◽

Clinical Characteristics ◽

Neuropsychiatric Disorders ◽

Acute Onset ◽

Future Research ◽

Streptococcal Infections ◽

Comorbid Conditions

This chapter discusses the nature and clinical characteristics associated with both pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). Clinical features, etiology and course, and appropriate diagnosis and assessment approaches are discussed. Common comorbid conditions, both psychiatric and medical, associated with PANS are also described. Syndromal features that uniquely characterize PANS presentations of OCD are illustrated. Extent data on immune-focused and psychiatric treatments are discussed, including means for addressing complex presentations and multiply comorbid cases, and interventions in multiple settings (such as school, clinic, and community). The chapter concludes with a discussion of future research.

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Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections

FOCUS The Journal of Lifelong Learning in Psychiatry ◽

10.1176/foc.2.3.496 ◽

2004 ◽

Vol 2 (3) ◽

pp. 496-506 ◽

Cited By ~ 7

Author(s):

Susan E. Swedo ◽

Henrietta L. Leonard ◽

Marjorie Garvey ◽

Barbara Mittleman ◽

Albert J. Allen ◽

...

Keyword(s):

Neuropsychiatric Disorders ◽

Streptococcal Infections

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39.2 RANDOMIZED, CONTROLLED TRIAL OF INTRAVENOUS IMMUNOGLOBULIN FOR PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2016.07.672 ◽

2016 ◽

Vol 55 (10) ◽

pp. S60-S61

Author(s):

Kyle A. Williams

Keyword(s):

Randomized Controlled Trial ◽

Intravenous Immunoglobulin ◽

Controlled Trial ◽

Neuropsychiatric Disorders ◽

Streptococcal Infections ◽

Randomized Controlled

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Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

10.21203/rs.2.19372/v3 ◽

2020 ◽

Author(s):

Lorenzo Loffredo ◽

Alberto Spalice ◽

Francesca Salvatori ◽

De Castro Giovanna ◽

Cristiana Alessia Guido ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Prostaglandin F2α ◽

Neuropsychiatric Disorders ◽

Serum Levels ◽

Multiple Linear Regression Analysis ◽

Tic Disorders ◽

Streptococcal Infections ◽

Cross Sectional

Abstract Background: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to assess NOX2 levels, as well as serum 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) derived from Gram-negative bacteria in the gut of patients with PANDAS. Methods: a cross sectional study was performed to compare serum levels of soluble NOX2-dp (sNOX-2-dp), isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used to assess gut permeability. Results: compared with CT, PANDAS children had higher values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was signiﬁcantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). LPS signiﬁcantly correlated with serum zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). A multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Isoprostanes and zonulin emerged as the only independent predictive variables associated with sNOX2-dp (R2=68%). Conclusion: this study provides evidences that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be potentially implicated in the process of neuroinflammation.

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Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

Journal of Medical - Clinical Research & Reviews ◽

10.33425/2639-944x.1229 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Mohammad O AL fattani ◽

Asmaa M Al Refaie ◽

Shuruq Hassan Alsulami ◽

Najia Al Hojaili

Keyword(s):

Febrile Illness ◽

Neuropsychiatric Disorders ◽

Age Group ◽

Pediatric Age ◽

Streptococcal Infections ◽

Obsessive Compulsive ◽

Tic Disorder ◽

Compulsive Disorder ◽

Pediatric Age Group ◽

Suicidal Attempts

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a rear disease in pediatric age group which constitute a unique manifestation associated with obsessive-compulsive disorder (OCD) and tic disorder in children. However, this diagnosis has carried a lot of controversies, related mainly to its management. Here we are presenting one case of PANDAS syndrome who was treated successfully with full coarse of antibiotic for 10 days, where all his symptoms disappeared completely in subsequent days including suicidal attempts. PANDAS should be considered in children with neuropsychiatric disorders (tics, obsessive behavior etc.) especially if symptoms associated within a period of infection such as febrile illness or sore throats.

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