Strep Throat in Kids/PANDAS

[brewer]

Nope, not the bear. An autoimmune neuropsych disorder associated with the infection.
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Do PANDAS Really Exist?

Barbara Geller, MD Reviewing Orlovska S et al., JAMA Psychiatry 2017 May 24;

After both streptococcal and other infections, children had higher risks for obsessive-compulsive disorder, tics, and any mental disorder in a Danish population and sibling study.
Controversy about the existence of pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infection (PANDAS) is based on equivocal evidence from studies of molecular mimicry (antibodies to streptococcus that interact with basal ganglia), response of psychopathology to antibiotic treatment, and the relationship between recurring infections and onset of symptoms of obsessive-compulsive disorder (OCD). This population-level study used Danish registries for all births between 1996 and 2013 (approximately 1.1 million children); follow-up lasted ≤17 years.

Analyses controlled for socioeconomic status, parental mental disorders, and personal or parental autoimmune disorders. Children with a positive streptococcal test had higher risks for OCD (51%), tic disorders (35%), and any mental disorder (18%) than children without testing. Children with a negative streptococcal test — presumably conducted because of a non-strep infection — also had higher risks for OCD (28%), tic disorder (25%), and any mental disorder (8%). Compared with siblings with a negative strep test, children with a positive test had a 94% higher risk for OCD.

Comment

These data provide support for children's increased risks for OCD, tics, and any mental disorder after both strep infections (PANDAS) and non-strep infections, which have been referred to as pediatric acute-onset neuropsychiatric syndrome (PANS). One puzzling finding in this study is the lack of temporal association between strep infections and onset of psychopathology, because clinical symptoms of OCD are observed within weeks of the sore throat.

PANDAS and PANS are not common. But clinicians should consider these diagnoses when children present with a sudden onset of marked OCD symptoms after an infection, especially if there is no prior, or family, history of OCD.

http://jamanetwork.com/journals/jamapsyc...ct/2629065

[bennyboy]

What's causing this stuff? Are some infections getting past the blood brain barrier or something? Or is it the drugs that are used to treat the sickesses that do it?

[brewer]

What's causing this stuff?  Are some infections getting past the blood brain barrier or something?  Or is it the drugs that are used to treat the sickesses that do it?

It's probably been going on for ages but only recently is being recognized. NIMH can answer better than I.

Quote: "The strep bacteria is a very ancient organism which survives in its human host by hiding from the immune system as long as possible. It does this by putting molecules on its cell wall that look nearly identical to molecules found on the child’s heart, joints, skin, and brain tissues. This is called “molecular mimicry” and allows the strep bacteria to evade detection for a time.

However, the molecules on the strep bacteria are eventually recognized as foreign to the body and the child’s immune system reacts to them by producing antibodies. Because of the molecular mimicry, the antibodies react not only with the strep molecules, but also with the human host molecules that were mimicked.

The cross-reactive antibodies then trigger an immune reaction that “attacks” the mimicked molecules in the child’s own tissues. Studies at the NIMH and elsewhere showed that some cross-reactive “anti-brain” antibodies target the brain, causing OCD, tics, and the other neuropsychiatric symptoms of PANDAS."

Source: https://www.nimh.nih.gov/labs-at-nimh/re...ions.shtml

[bennyboy]

Holy fucking fuck. I don't know what else to say.

[brewer]

Holy fucking fuck.  I don't know what else to say.

Have your kids checked and treated early.