| Literature DB >> 29309797 |
Sofia Sigra1, Eva Hesselmark2, Susanne Bejerot3.
Abstract
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a subtype of acute-onset obsessive-compulsive disorder (OCD) thought to be caused by an autoimmune response to group A streptococcal infection. Based on this proposed pathophysiology, alternative treatments for acute-onset OCD have been introduced, including antibiotics and immunomodulatory interventions. However, the literature on treatment of PANDAS is diverse, and clinical consensus regarding optimal treatment strategy is lacking. We conducted a systematic review of articles in PubMed, Cochrane Library, and Scopus that addressed treatment for PANDAS and related disorders. Twelve research studies involving the following treatments met inclusion criteria: penicillin, azithromycin, intravenous immunoglobulin, plasma exchange, tonsillectomy, cognitive behavior therapy, NSAID and corticosteroids. In addition, 65 case reports in which patients received immunomodulatory treatments, antibiotics, and/or psychotropics were identified. We determined that rigorously conducted research regarding treatments for PANDAS is scarce, and published studies have a high risk of bias. Further research is needed in which promising treatment strategies for PANDAS and other variants of OCD with proposed autoimmune etiology are rigorously investigated.Entities:
Keywords: CANS; Childhood acute neuropsychiatric symptoms; OCD; Obsessive-compulsive disorder; Obsessive-compulsive symptoms; PANDAS; PANS; PITAND; Pediatric acute-onset neuropsychiatric syndrome; Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections; Systematic review; Therapy; Treatment
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Year: 2018 PMID： 29309797 DOI： 10.1016/j.neubiorev.2018.01.001
Source DB: PubMed Journal: Neurosci Biobehav Rev ISSN： 0149-7634 Impact factor: 8.989