Last modified: 2014-04-03
Abstract
Title: PANDAS Diagnosis in the Ultimate Context of Pediatric Neurology. Introduction: PANDAS is defined as Pediatric Autoimmune Neuropsychiatric Disease Associated with Streptococcus Infection and is a current topic still described with disagreements in some aspects. Knowing that GABHS is a common agent that causes pharingitis in children and OCD and tics are prevalent at this age group, this study becomes relevant. Methods: Forty articles from revised, cross-sectional, and case-control nature, which only human-being studies were selected. The Portuguese and English languages were utilized, and the research timeframe is between 1995 and 2012. Results: The term PANDAS was first mentioned by Swedo in 1996 and describes a childhood condition in which tics and OCD are triggered by GABHS. Its physiopathology involves molecular mimicry, what is explained by a cross reaction between basal ganglia cells and antibodies against the antigen epitope. Thus, the auto-antibodies’ serum levels and protein CaM kinase II; the basal ganglia enlargement observed in magnetic resonance images; and the streptococcia’s confirmation by serum levels of ASLO and anti-DNase are useful in the diagnosis. Nevertheless, its treatment is still questioned because autoimmunity can be treated with PMF and IVIM, but prophylaxis cannot be utilized for the infection. In the short term, Penicillin is indicated to eliminate the infectious agent if streptococcia is confirmed. Conclusion: The clinical characteristics concerning PANDAS must always be taken into consideration when approaching patients with tics and/or OCD in order to perform a premature diagnosis. Regarding its prevention, studies approaching antibiotic prophylaxis are still required.
Keywords
References
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