Neuropsychiatric consequences of childhood group A streptococcal infection: A systematic review of preclinical models

Santiago Mora, Elena Martín-González, Pilar Flores, Margarita Moreno
Brain, Behavior, and Immunity-2019

Preclinical Animal Models are advancing our knowledge of Post-Infectious BGE

  • Preclinical GAS exposure induced behavioural abnormalities in different paradigms
  • Alterations induced by preclinical GAS exposure resemble those by LPS and Poly I:C.
  • Preclinical GAS exposure increase vulnerability to neuropsychiatric disorders.
  • Preclinical GAS exposure is a valid model for studying streptococcal consequences.
Maternal thyroid autoimmunity associated with acute-onset neuropsychiatric disorders and global regression in offspring

Jones HF, Ho ACC, Sharma S, Mohammad SS, Kothur K, Patel S, Brilot F, Guastella AJ, Dale RC; Immune-Neurodevelopment (Imm-Nd) Study Group.
Dev Med Child Neurology-2019

Abstract: Epidemiological studies, animal models, and case–control studies indicate maternal immune activation may be an important factor involved in disease expression of autism spectrum disorder (ASD), Tourette syndrome, and obsessive–compulsive disorder (OCD). We report eight children (mean age 6y 6mo [range 4–15y]; six males and two females) referred over a 2‐year period with at least one of these neurodevelopmental disorders plus a maternal history of thyroid autoimmunity…

PANDAS and PANS: Clinical, Neuropsychological, and Biological Characterization of a Monocentric Series of Patients and Proposal for a Diagnostic Protocol

Gamucci A, Uccella S, Sciarretta L, D’Apruzzo M, Calevo MG, Mancardi MM, Veneselli E, De Grandis E.
J Child Adolesc Psychopharmacology-2019

Conclusions: Despite these limitations, this study presents clinical, biological, and psychological features of a group of patients fulfilling the PANS and PANDAS criteria and discusses these results in comparison with patients with SC, a well-established clinical condition. Moreover, it adds notable findings to the existing little literature on neuropsychological functioning in youth diagnosed with these disorders, in particular PANS and PANDAS…

Psychometric Properties of the Pediatric Acute-Onset Neuropsychiatric Syndrome Global Impairment Score in Children and Adolescents with Pediatric Acute-Onset Neuropsychiatric Syndrome

Leibold C, Thienemann M, Farhadian B, Willett T, Frankovich J.
J Child Adolesc Psychopharmacololgy-2019

Results: The GIS shows excellent discriminant validity, distinguishing patients with PANS from healthy controls. The scores on the GIS show an acceptable level of agreement with the clinician-reported CGAS. The regression line in the Bland–Altman plot had a positive slope, indicating that parents tend to report higher disease severity than clinicians at higher levels of disease severity. Correlation was higher during disease remissions than during disease flares (r = −0.69 vs. r = −0.48). All disease severity scales predicted GIS in the expected direction

European Advocacy Organizations Response to PANDAS/PANS Article

Gerland Gunilla, Mogyorosi-Post, Anita, Cafferky Karen, Galardini Giuliana, Granli Kristin, Tuckey Georgia.
Journal of Pediatrics-2018

As representatives of the pediatric acute-onset neuropsychiatric syndrome (PANS)/pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) organizations in Europe, we have concerns about the commentary by Gilbert et al,1 given its potential to negatively influence the treatment of children suffering from these devastating conditions.

The Burden of Caring for a Child or Adolescent With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): An Observational Longitudinal Study

Frankovich J, Leibold CM, Farmer C, Sainani K, Kamalani G, Farhadian B, Willett T, Park JM, Sidell D, J
Clin Psychiatry-2018

Conclusions: PANS caregivers suffer high caregiver burden. Neuropsychiatric disease severity predicts increased caregiver burden. Caregiver burden tends to decrease over time in a group of patients undergoing clinical treatment at a specialty PANS clinic. This decrease could be independent of clinical treatment.

Allergic Diseases and Immune-Mediated Food Disorders in Pediatric Acute-Onset Neuropsychiatric Syndrome

Rosa JS, Hernandez JD, Sherr JA, Smith BM, Brown KD, Farhadian B, Mahony T, McGhee SA, Lewis DB, Thienemann M, Frankovich JD.
Pediatr Allergy Immunol Pulmonology-2018

Conclusions: The prevalence of allergic and immune-mediated food disorders in PANS is similar to the general population as reported in the literature, with the exception of AR that appears to be more prevalent in our PANS cohort. More research will be required to establish whether diet or allergies influence PANS symptoms.

The Diagnostic Value of Serological Studies in Pediatric Patients with Acute Mycoplasma Pneumoniae Infection

Lin LJ, Chang FC, Chi H, Jim WT, Tsung-Ning Huang D, Kung YH, Chiu NC, Chang L.
Journal of Microbiology, Immunology, and Infection-2018

In the pediatric population, combined serological tests of M. pneumoniae IgA and IgM, offer an accurate method of early diagnosis comparable to that of PCR, and can be an alternative choice for prompt detection of mycoplasma infections when PCR and culture are not available.