Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology
Background. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) syndrome is a rare pediatric disorder consisting of a sudden onset of obsessive–compulsive disorder (OCD) and/or tics after a group A Streptococcus (GAS) infection. Methods. In the period be...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-12-01
|
| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/12/1/8 |
| _version_ | 1827369540883841024 |
|---|---|
| author | Saverio La Bella Marina Attanasi Armando Di Ludovico Giovanna Scorrano Francesca Mainieri Francesca Ciarelli Federico Lauriola Luisa Silvestrini Virginia Girlando Francesco Chiarelli Luciana Breda |
| author_facet | Saverio La Bella Marina Attanasi Armando Di Ludovico Giovanna Scorrano Francesca Mainieri Francesca Ciarelli Federico Lauriola Luisa Silvestrini Virginia Girlando Francesco Chiarelli Luciana Breda |
| author_sort | Saverio La Bella |
| collection | DOAJ |
| description | Background. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) syndrome is a rare pediatric disorder consisting of a sudden onset of obsessive–compulsive disorder (OCD) and/or tics after a group A Streptococcus (GAS) infection. Methods. In the period between 2013 and 2023, 61 children presented to our Pediatric Rheumatology unit with a suspicion of PANDAS syndrome. Among these, a retrospective analysis was conducted, and 19 fulfilled the current classification criteria and were included in this study. Results. The male-to-female ratio was 14:5, the median age at onset was 7.0 (2.0–9.5) years, and the median age at diagnosis was 8.0 (3.0–10.4) years. The median follow-up period was 16.0 (6.0–72.0) months. Family and personal history were relevant in 7/19 and 6/19 patients. Tics were present in all patients. Details for motor tics were retrospectively available in 18/19 patients, with the eyes (11/18) and neck/head (10/18) being most often involved. Vocal tics were documented in 8/19, behavioral changes in 10/19, and OCD in 2/19. Regarding the therapeutic response, all patients responded to amoxicillin, 12/13 to benzathine benzylpenicillin, and 7/9 to azithromycin. Conclusions. Our findings partially overlap with previous reports. Larger prospective studies are needed to improve treatment strategies and classification criteria. |
| first_indexed | 2024-03-08T09:50:55Z |
| format | Article |
| id | doaj.art-76f33130086a4b758c2bc8fefd3a9426 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-08T09:50:55Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-76f33130086a4b758c2bc8fefd3a94262024-01-29T14:05:26ZengMDPI AGMicroorganisms2076-26072023-12-01121810.3390/microorganisms12010008Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric RheumatologySaverio La Bella0Marina Attanasi1Armando Di Ludovico2Giovanna Scorrano3Francesca Mainieri4Francesca Ciarelli5Federico Lauriola6Luisa Silvestrini7Virginia Girlando8Francesco Chiarelli9Luciana Breda10Department of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, ItalyBackground. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) syndrome is a rare pediatric disorder consisting of a sudden onset of obsessive–compulsive disorder (OCD) and/or tics after a group A Streptococcus (GAS) infection. Methods. In the period between 2013 and 2023, 61 children presented to our Pediatric Rheumatology unit with a suspicion of PANDAS syndrome. Among these, a retrospective analysis was conducted, and 19 fulfilled the current classification criteria and were included in this study. Results. The male-to-female ratio was 14:5, the median age at onset was 7.0 (2.0–9.5) years, and the median age at diagnosis was 8.0 (3.0–10.4) years. The median follow-up period was 16.0 (6.0–72.0) months. Family and personal history were relevant in 7/19 and 6/19 patients. Tics were present in all patients. Details for motor tics were retrospectively available in 18/19 patients, with the eyes (11/18) and neck/head (10/18) being most often involved. Vocal tics were documented in 8/19, behavioral changes in 10/19, and OCD in 2/19. Regarding the therapeutic response, all patients responded to amoxicillin, 12/13 to benzathine benzylpenicillin, and 7/9 to azithromycin. Conclusions. Our findings partially overlap with previous reports. Larger prospective studies are needed to improve treatment strategies and classification criteria.https://www.mdpi.com/2076-2607/12/1/8PANDASPANDAS syndromestreptococcuspediatric autoimmune neuropsychiatric disorders associated with streptococcal infectionsantibioticsGAS |
| spellingShingle | Saverio La Bella Marina Attanasi Armando Di Ludovico Giovanna Scorrano Francesca Mainieri Francesca Ciarelli Federico Lauriola Luisa Silvestrini Virginia Girlando Francesco Chiarelli Luciana Breda Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology Microorganisms PANDAS PANDAS syndrome streptococcus pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections antibiotics GAS |
| title | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology |
| title_full | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology |
| title_fullStr | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology |
| title_full_unstemmed | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology |
| title_short | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) Syndrome: A 10-Year Retrospective Cohort Study in an Italian Centre of Pediatric Rheumatology |
| title_sort | pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections pandas syndrome a 10 year retrospective cohort study in an italian centre of pediatric rheumatology |
| topic | PANDAS PANDAS syndrome streptococcus pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections antibiotics GAS |
| url | https://www.mdpi.com/2076-2607/12/1/8 |
| work_keys_str_mv | AT saveriolabella pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT marinaattanasi pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT armandodiludovico pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT giovannascorrano pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT francescamainieri pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT francescaciarelli pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT federicolauriola pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT luisasilvestrini pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT virginiagirlando pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT francescochiarelli pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology AT lucianabreda pediatricautoimmuneneuropsychiatricdisordersassociatedwithstreptococcalinfectionspandassyndromea10yearretrospectivecohortstudyinanitaliancentreofpediatricrheumatology |