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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