Implications for Advanced Practice Nurses When Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS) Is Suspected: A Qualitative Study

McClelland, Molly; Crombez, Mary-Margaret; Crombez, Catherine; Wenz, Catherine; Lisius, Margaret; Mattia, Amanda; Marku, Suzana

doi:10.1016/j.pedhc.2015.03.005

Cited by 12 publications

(4 citation statements)

References 33 publications

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“…They may avoid social settings as they are worried or anxious that others may notice these behaviors (Bernstein et al, 2010), and families may experience challenges participating in activities as well (Tona et al, 2017). Parents whose children have PANDAS and PANS also have reported a deterioration of community and family social participation during exacerbations, as well as decreased socialization as a family (Tona et al, 2017); these parents are at risk for emotional difficulties and frequently experience fear and isolation (McClelland et al, 2015). Families of children with PANS demonstrate greater caregiver burden than families of individuals with Alzheimer's disease (Farmer et al, 2018).…”

Section: Social-emotional and Behavioralmentioning

confidence: 99%

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

Hoppin¹,

Doran²

2023

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I n the mid-1990s, researchers at the National Institute of Mental Health (NIMH) identified a link between recent streptococcal infection and the development of neuropsychiatric symptoms such as separation anxiety, tics, behavioral regression, rage, restricted eating, and obsessive-compulsive disorder (OCD;Swedo et al., 1998). ETIOLOGYResearch has found that in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS), exposure to an infection or other agent that activates the immune system creates an immune response that goes awry, causing autoantibodies (or immune cells) to attack brain cells instead (Chang et al., 2015;Platt et al., 2017). The resulting inflammation causes obsessions, compulsions, hallucinations, restricted eating, motor difficulties and tics, behavioral challenges, and other symptoms. PANDAS and PANS typically have a distinct onset (Chang et al., 2015); however, if symptoms are mild at first, parents and clinicians may initially overlook the change in behavior as part of typical development (Rice Doran, 2016b).

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Section: Social-emotional and Behavioralmentioning

confidence: 99%

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

Hoppin¹,

Doran²

2023

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“…Childhood-onset obsessive compulsive disorder (OCD) or tic disorders associated with acute Group A beta-hemolytic disorders (PANDAS) should be evaluated for pediatric autoimmune neuropsychiatric disorders. In particular, the dramatic onset or exacerbation of the disease should be considered as an important finding [1].…”

Section: Overviewmentioning

confidence: 99%

Neuropsychıatrıc dısorders assocıated wıth chıldhood ımmunologıc dysfunctıon

Korkmaz,

Keskin

2023

IWPNZ

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Introduction. These disease entities are known as pediatric neuropsychiatric syndromes because infectious pathogens other than streptococci have also been reported to be associated with neuropsychiatric symptoms. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). Aim. The aim of this study was to evaluate neuropsychiatric disorders associated with immunologic dysfunction in childhood. Overview. PANS/PANDAS refers to the acute and dramatic onset of a neuropsychiatric syndrome in children, including OCD and/or tics. It is believed to be the result of an autoimmune reaction to the basal ganglia nuclei, initiated by infection with group A streptococci. Studies indicate neuroinflammatory reactions in the basal ganglia and related networks. Conclusions. Evaluating treatment strategies for PANS/PANDAS remains a challenge because it is a rare disease with few published high-quality studies. Little is known about its etiology, diagnostic methods, treatments or long-term effects. However, as hundreds of children and families suffer from the debilitating effects of the disease, infectious diseases should be carefully evaluated for PANS/PANDAS, especially in the pediatric age group. Even in the absence of evidence on which to base interventions, it is within the scope of advanced nursing practice to provide psychotherapeutic care with an empathetic perspective to children and families struggling with the frustration, fear and anxiety caused by illness.

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“…All things considered, the controversy over PANDAS has equally affected doctors, children, and their families significantly [7]. Concerns and intense emotions of the family members whose children are diagnosed with this phenotype have received significant attention on social media and are well-documented in the news [8]. The reasons behind PANDAS having a great impact on so many levels and populations include a wide range of clinical diagnostic challenges, treatment options that are under discussion, and long-term complications, on top of the fact that none of them has benefited from a clear and standard conclusion [1].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Autoimmune Neuropsychiatric Disorders Associated With Group A Streptococci: Etiopathology and Diagnostic Challenges

Hutanu¹,

Reddy²,

Mathew³

et al. 2022

Cureus

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Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) have attracted a lot of interest and discussion since it was originally characterized in 1998. The role of streptococcal infection in children with abrupt-onset obsessive-compulsive disorder (OCD) and new-onset tics, the natural history of this entity, and the role of symptomatic and disease-modifying therapies, such as antibiotics, immunotherapy, and psychoactive drugs, are still unresolved issues. Alternative therapies for acute-onset OCD have been developed based on this postulated pathophysiology, including antibiotics and immunomodulatory therapy. The literature on PANDAS therapy is varied but there is no clinical consensus on the treatment of choice.While there is no convincing evidence for the autoimmune rationale for PANDAS, given the increased attention to this entity and the apparent growth in usage of this diagnostic category, it is critical to address concerns about the condition's diagnosis, treatment, and pathogenesis.We conducted a multi-language literature search on Medline, Cochrane, Embase, and Google Scholar for a period spanning until October 2021. The following search strings and Medical Subject Heading (MeSH) terms were used: "PANDAS," "Group A Streptococcus," "OCD," and "tics." We explored the literature on PANDAS in terms of its epidemiology, pathophysiology, the role of group A streptococcal infection, associated complications, and prophylactic and treatment modalities.We examined current working definitions of PANDAS, analyzed differential diagnoses, and published pieces of evidence for therapies associated with this entity, with a view to proposing a therapeutic strategy for children with acute symptoms that meet PANDAS criteria, in this review article.

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Implications for Advanced Practice Nurses When Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS) Is Suspected: A Qualitative Study

Cited by 12 publications

References 33 publications

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

Neuropsychıatrıc dısorders assocıated wıth chıldhood ımmunologıc dysfunctıon

Pediatric Autoimmune Neuropsychiatric Disorders Associated With Group A Streptococci: Etiopathology and Diagnostic Challenges

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