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What every psychiatrist should know about PANDAS: a review

Germana Moretti email, Massimo Pasquini email, Gabriele Mandarelli email, Lorenzo Tarsitani email and Massimo Biondi email

Department of Psychiatric Sciences and Psychological Medicine, "Sapienza" University of Rome, Viale dell'Univeristà 30, 00185, Rome, Italy

author email corresponding author email

Clinical Practice and Epidemiology in Mental Health 2008, 4:13doi:10.1186/1745-0179-4-13

Published: 21 May 2008

Abstract

The term Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infections (PANDAS) was coined by Swedo et al. in 1998 to describe a subset of childhood obsessive-compulsive disorders (OCD) and tic disorders triggered by group-A beta-hemolytic Streptococcus pyogenes infection. Like adult OCD, PANDAS is associated with basal ganglia dysfunction. Other putative pathogenetic mechanisms of PANDAS include molecular mimicry and autoimmune-mediated altered neuronal signaling, involving calcium-calmodulin dependent protein (CaM) kinase II activity. Nonetheless the contrasting results from numerous studies provide no consensus on whether PANDAS should be considered as a specific nosological entity or simply a useful research framework. Herein we discuss available data that could provide insight into pathophysiology of adult OCD, or might explain cases of treatment-resistance. We also review the latest research findings on diagnostic and treatment.


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