OBJECTIVE: The objective of this blinded, prospective, longitudinal study was to determine whether new group A β hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or OC disorder without a PANDAS history served as the comparison (non-PANDAS) group. METHOD: Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25-month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHS infections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results. RESULTS: No group differences were observed in the number of clinical exacerbations or the number of newly diagnosed GABHS infections. On only six occasions of a total of 51 (12%), a newly diagnosed GABHS infection was followed, within 2 months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group. CONCLUSIONS: This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria.
OBJECTIVE: The objective of this blinded, prospective, longitudinal study was to determine whether new group A β hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or OC disorder without a PANDAS history served as the comparison (non-PANDAS) group. METHOD: Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25-month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHSinfections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results. RESULTS: No group differences were observed in the number of clinical exacerbations or the number of newly diagnosed GABHSinfections. On only six occasions of a total of 51 (12%), a newly diagnosed GABHSinfection was followed, within 2 months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group. CONCLUSIONS: This study provides no evidence for a temporal association between GABHSinfections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria.
Authors: Feng Luo; James F Leckman; Liliya Katsovich; Diane Findley; Heidi Grantz; Daniel M Tucker; Paul J Lombroso; Robert A King; Debra E Bessen Journal: Pediatrics Date: 2004-06 Impact factor: 7.124
Authors: Ivana Kawikova; James F Leckman; Holger Kronig; Lily Katsovich; Debra E Bessen; Musie Ghebremichael; Alfred L M Bothwell Journal: Biol Psychiatry Date: 2006-09-25 Impact factor: 13.382
Authors: Eliana Miller Perrin; Marie Lynd Murphy; Janet R Casey; Michael E Pichichero; Desmond K Runyan; William C Miller; Lisa A Snider; Susan E Swedo Journal: Arch Pediatr Adolesc Med Date: 2004-09
Authors: Susan E Swedo; Jakob Seidlitz; Miro Kovacevic; M Elizabeth Latimer; Rebecca Hommer; Lorraine Lougee; Paul Grant Journal: J Child Adolesc Psychopharmacol Date: 2015-02 Impact factor: 2.576
Authors: Eli R Lebowitz; Maria G Motlagh; Liliya Katsovich; Robert A King; Paul J Lombroso; Heidi Grantz; Haiqun Lin; Mary Jane Bentley; Donald L Gilbert; Harvey S Singer; Barbara J Coffey; Roger M Kurlan; James F Leckman Journal: Eur Child Adolesc Psychiatry Date: 2012-04-28 Impact factor: 4.785