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2015, Cilt 45, Sayı 3, Sayfa(lar) 109-116
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PANDAS Hypothesis
Hasan Cenk MİRZA
Merzifon Devlet Hastanesi, Mikrobiyoloji Laboratuvarı, Amasya
Keywords: Streptococcus, tic disorder, PANDAS

The term “pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)” which was first defined by Swedo et al. in 1998, has been used to express the childhood neuropsychiatric disorders [obsessivecompulsive disorders and tic disorders] that are thought to have an autoimmune basis and to be triggered by group A beta-hemolytic streptococci. It is still unclear whether PANDAS hypothesis is a well-defined, isolated clinical entity because other infectious agents like viruses and other bacteria have also been reported to be associated with obsessive-compulsive disorder or tic disorders. Also psychiatric and neurological pathologies such as “anorexia nervosa” and “acute disseminated encephalomyelitis” which were not included in the diagnostic criteria of PANDAS have been shown to be associated with group A beta-hemolytic streptococci infections. Inconsistencies have been seen in the results of the studies which investigated the association between group A beta-hemolytic streptococci and symptoms, immune-mediated basis of PANDAS and the treatment options in PANDAS represent. So far, the information about PANDAS is often derived from relatively small, retrospective, uncontrolled studies or case reports. Larger, well-designed, prospective studies are necessary to remodelling the definition and diagnostic criteria of PANDAS. In this review etiology, pathogenesis, immunology, clinical signs and treatment options of PANDAS were discussed.

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