Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran
Introduction: Group A Beta-Hemolytic Streptococcus (GABHS) can induce PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection). GABHS is the most important and common bacterial cause of acute pharyngitis in Iranian children. We studied the role of GABHS (anti-...
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| Format: | Article |
| Language: | English |
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Iran University of Medical Sciences
2015-02-01
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| Series: | Basic and Clinical Neuroscience |
| Subjects: | |
| Online Access: | http://bcn.iums.ac.ir/browse.php?a_code=A-10-200-3&slc_lang=en&sid=1 |
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| author | Farideh Ebrahimi Taj Samileh Noorbakhsh Sahar Ghavidel Darestani Elham Shirazi Shima Javadinia |
| author_facet | Farideh Ebrahimi Taj Samileh Noorbakhsh Sahar Ghavidel Darestani Elham Shirazi Shima Javadinia |
| author_sort | Farideh Ebrahimi Taj |
| collection | DOAJ |
| description | Introduction: Group A Beta-Hemolytic Streptococcus (GABHS) can induce PANDAS
(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection).
GABHS is the most important and common bacterial cause of acute pharyngitis in Iranian
children. We studied the role of GABHS (anti-streptococcal antibodies) in suspected cases of
PANDAS in a cross sectional studies. Methods: Across sectional study was done in 2 pediatric psychiatric /and neurologic clinics
in Tehran (Rasul Akram and Aliasghar Hospital) during 2008-2010. We studied serum antistreptococcal
antibodies (anti streptolysin O, anti Deoxyribonuclease B, and anti-streptokinase
(ABcam-ELISA, USA) in 76 cases with psychiatric manifestation (OCD, ADHD) in compare
with 39 healthy controls. These antibodies were studied in 53 cases with movement disorders
(Tic/ Tourette syndrome ) in compare with 76 healthy controls. Sensitivity, specificity and
positive predictive value of tests were calculated. Results: In movement disorders ASOT, Anti-DNase and Anti streptokinase was significantly
higher than controls (p<0.0001, p=0.000, p 200IU/ml) had 75% sensitivity 84% specificity and 80% PPV Antistreptokinase
(cut off level> 332 IU/ml) had 34% sensitivity 85% specificity, and 72% PPV
Anti-DNase (cut off level> 140IU/ml) had 70% sensitivity 99% specificity and PPV 90% for
differentiating the group. ASOT, Anti-DNase and Anti streptokinase titer was significantly higher
than controls (p<0.0001, p=0.000, p<0.0001). ASOT had 90% sensitivity 82% specificity,
PPV 92% Anti streptokinase: 82% sensitivity 82% specificity, PPV 95% Anti DNase: 92%
sensitivity 82% specificity, PPV 92% for differentiation the cases from normal controls. Discussion: These findings support that a post infectious immune mechanism to GABHS
may play a role in the pathogenesis of PANDAS in our children. A combination of throat
culture, rapid antigen detection test, and serologic testing for GABHS is required to achieve
maximum sensitivity and specificity for diagnosis. We prefer to use antibiotic prophylaxis in
PANDAS cases for preventing recurrent streptococcal infections. Ongoing research is needed
for identifying optimum diagnostic, prevention and therapeutic approach especially, aggressive
treatment (intravenous immunoglobulin, plasmaphresis). |
| first_indexed | 2024-03-07T17:24:58Z |
| format | Article |
| id | doaj.art-239df045a5494f07a105471bc6e7c1f8 |
| institution | Directory Open Access Journal |
| issn | 2008-126X 2228-7442 |
| language | English |
| last_indexed | 2024-03-07T17:24:58Z |
| publishDate | 2015-02-01 |
| publisher | Iran University of Medical Sciences |
| record_format | Article |
| series | Basic and Clinical Neuroscience |
| spelling | doaj.art-239df045a5494f07a105471bc6e7c1f82024-03-02T19:16:35ZengIran University of Medical SciencesBasic and Clinical Neuroscience2008-126X2228-74422015-02-01613843Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, IranFarideh Ebrahimi Taj0Samileh Noorbakhsh1Sahar Ghavidel Darestani2Elham Shirazi3Shima Javadinia4 Department of Pediatric Psychology, Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Department of Pediatric Psychology, Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran ENT & Head & Neck surgery Research center, Iran University of Medical Sciences, Tehran, Iran Department of Pediatric Psychology, Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Department of Pediatric Psychology, Research Center of Pediatric Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Introduction: Group A Beta-Hemolytic Streptococcus (GABHS) can induce PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection). GABHS is the most important and common bacterial cause of acute pharyngitis in Iranian children. We studied the role of GABHS (anti-streptococcal antibodies) in suspected cases of PANDAS in a cross sectional studies. Methods: Across sectional study was done in 2 pediatric psychiatric /and neurologic clinics in Tehran (Rasul Akram and Aliasghar Hospital) during 2008-2010. We studied serum antistreptococcal antibodies (anti streptolysin O, anti Deoxyribonuclease B, and anti-streptokinase (ABcam-ELISA, USA) in 76 cases with psychiatric manifestation (OCD, ADHD) in compare with 39 healthy controls. These antibodies were studied in 53 cases with movement disorders (Tic/ Tourette syndrome ) in compare with 76 healthy controls. Sensitivity, specificity and positive predictive value of tests were calculated. Results: In movement disorders ASOT, Anti-DNase and Anti streptokinase was significantly higher than controls (p<0.0001, p=0.000, p 200IU/ml) had 75% sensitivity 84% specificity and 80% PPV Antistreptokinase (cut off level> 332 IU/ml) had 34% sensitivity 85% specificity, and 72% PPV Anti-DNase (cut off level> 140IU/ml) had 70% sensitivity 99% specificity and PPV 90% for differentiating the group. ASOT, Anti-DNase and Anti streptokinase titer was significantly higher than controls (p<0.0001, p=0.000, p<0.0001). ASOT had 90% sensitivity 82% specificity, PPV 92% Anti streptokinase: 82% sensitivity 82% specificity, PPV 95% Anti DNase: 92% sensitivity 82% specificity, PPV 92% for differentiation the cases from normal controls. Discussion: These findings support that a post infectious immune mechanism to GABHS may play a role in the pathogenesis of PANDAS in our children. A combination of throat culture, rapid antigen detection test, and serologic testing for GABHS is required to achieve maximum sensitivity and specificity for diagnosis. We prefer to use antibiotic prophylaxis in PANDAS cases for preventing recurrent streptococcal infections. Ongoing research is needed for identifying optimum diagnostic, prevention and therapeutic approach especially, aggressive treatment (intravenous immunoglobulin, plasmaphresis).http://bcn.iums.ac.ir/browse.php?a_code=A-10-200-3&slc_lang=en&sid=1Group A ß-hemolytic streptococcus (GABHS) PANDAS (pediatric autoimmune neuropsychiatric disorders) OCD (obsessive-compulsive disorder) ADHD syndrome (attention deficient hyperactive disorders) Tic Tourette syndrome . |
| spellingShingle | Farideh Ebrahimi Taj Samileh Noorbakhsh Sahar Ghavidel Darestani Elham Shirazi Shima Javadinia Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran Basic and Clinical Neuroscience Group A ß-hemolytic streptococcus (GABHS) PANDAS (pediatric autoimmune neuropsychiatric disorders) OCD (obsessive-compulsive disorder) ADHD syndrome (attention deficient hyperactive disorders) Tic Tourette syndrome . |
| title | Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
| title_full | Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
| title_fullStr | Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
| title_full_unstemmed | Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
| title_short | Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
| title_sort | group a β hemolytic streptococcal infection in children and the resultant neuro psychiatric disorder a cross sectional study tehran iran |
| topic | Group A ß-hemolytic streptococcus (GABHS) PANDAS (pediatric autoimmune neuropsychiatric disorders) OCD (obsessive-compulsive disorder) ADHD syndrome (attention deficient hyperactive disorders) Tic Tourette syndrome . |
| url | http://bcn.iums.ac.ir/browse.php?a_code=A-10-200-3&slc_lang=en&sid=1 |
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