Recenzija, Prikaz slučaja

PANDAS: a case report

Ljiljana Perić ; KBC Osijek, Klinika za infektologiju, Osijek, Hrvatska
Denis Biondić ; KBC Osijek, Klinika za infektologiju, Osijek, Hrvatska

Sažetak

Pediatric autoimmune neuropsychiatric disorder associated with Streptococcus infections (PANDAS) was first described by Susan E. Swedo and colleagues in 1998, during the epidemic of rheumatic fever in the Ohio River Valley and Salt Lake City, noticing in these patients sudden onset of fear, loss of attention, tics and obsessive-compulsive symptoms. Since then, tics and/ or obsessive-compulsive disorders in predisposed children have been associated with autoimmune disorders of basal ganglia initiated by group Astreptococcus (GAS) infection. PANDAS syndrome should be considered in children who had a streptococcal infection, with the evidence of positive antibodies to antistreptolysin (ASO) and anti-DNase, and who later on developed an obsessive compulsive disorder and/or tics with episodic manifestations. A favorable therapeutic response after the application of intravenous immunoglobulin G and plasmapheresis supports the immune nature of this disease. We describe a case of an 18-year-old patient with frequent tics and obsessive-compulsive symptoms that began at the age of seven. He was treated with clindamycin twice (because of inflamed buccal mucosa after being bitten during tics). Afew weeks after the therapy with clindamycin tics significantly diminished. Previous therapy with immunoglobulin G on two occasions did not lead to improvement of symptoms. At each appearance of tics and/or obsessive-compulsive symptoms in children with previous streptococcal infection and confirmed GAS infection (throat swab, rising ASO titer) antibiotic prophylaxis with penicillin or clindamycin should be administered. Clindamycin in our patient proved more effective (inhibits the synthesis of bacterial superantigen, facilitates phagocytosis, has a long postantibiotic effect).

Ključne riječi

Streptococcus; autoimmune disease; brain

Hrčak ID:

98106

URI

https://hrcak.srce.hr/98106

Datum izdavanja:

30.9.2012.

Podaci na drugim jezicima: hrvatski

Posjeta: 10.806 *