What every psychiatrist should know about PANDAS: a review.
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.
Moretti
Germana
G
Department of Psychiatric Sciences and Psychological Medicine, "Sapienza" University of Rome, Viale dell'Univeristà 30, 00185, Rome, Italy. moretti.ge@tiscali.it.
Pasquini
Massimo
M
Mandarelli
Gabriele
G
Tarsitani
Lorenzo
L
Biondi
Massimo
M