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Treatment of PANDAS and PANS: a systematic review
Örebro University, School of Medical Sciences. University Health Care Research Center.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-3587-6075
2018 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 86, 51-56 p.Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 86, 51-56 p.
Keyword [en]
CANS, OCD, PANDAS, PANS, PITAND, Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, childhood acute neuropsychiatric symptoms, obsessive-compulsive disorder, obsessive-compulsive symptoms, pediatric acute-onset neuropsychiatric syndrome, systematic review, therapy, treatment
National Category
Medical and Health Sciences Psychiatry Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-64031DOI: 10.1016/j.neubiorev.2018.01.001PubMedID: 29309797OAI: oai:DiVA.org:oru-64031DiVA: diva2:1173194
Available from: 2018-01-11 Created: 2018-01-11 Last updated: 2018-01-12Bibliographically approved

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Sigra, SofiaBejerot, Susanne

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