314778

Clinicolaboratory characteristics of pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections: A cross-sectional study

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Clinical microbiology

Abstract

Background: A B-hemolytic streptococcal infections (GABHS) have been linked to obsessive-compulsive disorder (OCD) and tic disorders, leading to pediatric autoimmune neuropsychiatric diseases associated with streptococcal infections (PANDAS). This study aims to characterize the clinical and laboratory profile of a group of PANDAS patients and to relate between GABHS infection and their neuropsychiatric manifestations. Methods: a cross-sectional study was conducted between January2022 and January2023. We included all pediatric patients who had PANDAS using the following criteria: tic disorder and/or OCD; Presence of relationship between GABHS infection and disease onset and/or exacerbations. Streptococcal diagnosis for all cases was conducted using throat swab culture and measuring serum anti-streptolysin O(ASO) antibody titer, anti-deoxyribonuclease B (Anti Dnase B). Results: We diagnosed PANDAS in 76 patients. The mean age of patients was 6.8 ± 1.90 years. Motor tics occurred in 37 patients (48.7%), verbal tics in 6 patients (7.9%) and combined tics in 33 patients (43.4%). Attention deficit hyperactivity (ADH), Tourette syndrome, and OCD were identified in 27.6%, 18.4% and 15.8% of patients, respectively. Of all patients, 31 (40.8%) had pathologic Anti Dnase B antibody titer, 27 (35.5%) had pathologic (ASO) antibody titer, and GABHS were isolated from throats in 14 patients (18.4%). There was moderate agreement between GABHS throat culture and both ASO antibody titer (Kappa=0.58; p<0.001) and Anti Dnase antibody titer (Kappa=0.49; p<0.001). Of note, there was substantial agreement between ASO and Anti Dnase antibody titers (Kappa=0.78; p<0.001). Conclusion: The diagnosis of PANDAS requires careful assessment, including documentation of neuropsychiatric symptoms associated with evidence of GABHS infection.

DOI

10.21608/mid.2023.227202.1582

Keywords

Anti Dnase B, ASO, GABHS, OCD, tic disorders

Authors

First Name

Amr

Last Name

Risha

MiddleName

Ibrahim

Affiliation

Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt

Email

dr.amribrahim@ymail.com

City

-

Orcid

-

First Name

Mohamed

Last Name

Arafa

MiddleName

Ahmed

Affiliation

Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt

Email

moharafaped@gmail.com

City

-

Orcid

-

First Name

Mai

Last Name

Malek

MiddleName

Mohamed

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Egypt

Email

mmmuhammad@medicine.zu.edu.eg

City

Zagazig

Orcid

0000-0003-0297-0601

First Name

Tarek

Last Name

Abd El Aziz

MiddleName

Abd El Latef

Affiliation

Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt

Email

tareklatef43@gmail.com

City

-

Orcid

0000-0003-0893-6391

Volume

4

Article Issue

4

Related Issue

43799

Issue Date

2023-11-01

Receive Date

2023-08-05

Publish Date

2023-11-01

Page Start

1,255

Page End

1,265

Print ISSN

2682-4132

Online ISSN

2682-4140

Link

https://mid.journals.ekb.eg/article_314778.html

Detail API

https://mid.journals.ekb.eg/service?article_code=314778

Order

23

Type

Original Article

Type Code

1,157

Publication Type

Journal

Publication Title

Microbes and Infectious Diseases

Publication Link

https://mid.journals.ekb.eg/

MainTitle

Clinicolaboratory characteristics of pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections: A cross-sectional study

Details

Type

Article

Created At

25 Dec 2024