Immune mechanisms in pediatric neuropsychiatric disorders. Tourette's syndrome, OCD, and PANDAS.
The authors have reviewed recent data supporting the presence of immune abnormalities in several neuropsychiatric disorders (TS, OCD, and PANDAS). Several groups agree that there is a subset of patients with TS and OCD (perhaps about 10%) for whom there is a clear streptococcal trigger, validating the PANDAS concept. Also, evidence of biochemical markers for TS and OCD have begun to emerge, namely D8/17 and antibrain antibodies, which suggest the presence of similar immune abnormalities, even in idiopathic cases. If this line of research reveals definable, and relatively specific, immune abnormalities in at least some cases of TS and OCD, it will likely have important implications for the diagnosis and treatment of these common neuropsychiatric disorders, particularly in children who respond poorly to conventional therapies. Child psychiatrists are encouraged to stay tuned.
Trifiletti
R R
RR
Department of Neurology, Joan and Sanford I. Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA.
Packard
A M
AM
D000944:Antigens, Differentiation, B-Lymphocyte; D001327:Autoimmune Diseases / Q000235:genetics* / Q000276:immunology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D002819:Chorea / Q000235:genetics / Q000276:immunology* / Q000382:microbiology; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000235:genetics / Q000276:immunology*; D013290:Streptococcal Infections / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000472:pathogenicity*; D005879:Tourette Syndrome / Q000235:genetics / Q000276:immunology*
D000944:Antigens, Differentiation, B-Lymphocyte; D005819:Genetic Markers