Tonsillektomie bei PANDAS?

Abstract

establishing the diagnosis of PANDAS is complicated by underlying co-morbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity and unavoidable mortality rate it appears wise to indicate TE only in clinical studies with standardized inclusion criteria.

A critical review of PANDAS research in the context of obsessive compulsive disorder

“…Limitations of PANDAS treatment research also include a lack of consensus regarding treatment remedies and their hypothesized neurological action. A German case study review found that tonsillectomies had positive outcomes for children with PANDAS, but this may have been a result of post-operative treatment with antibiotics (Windfuhr, 2016). Considering the proposed travel of GAS-specific T cells through NALT after multiple exposures to the bacteria, the efficacy of tonsillectomies should be studied during various intervals, including initial symptoms or repeated infections.…”

Pandas Sy (Pedijatrijski Autoimuni Neuropsihijatrijski Poremećaj Udružen Sa Streptokoknom Infekcijom)

“…(povlačenje simptoma oko 50 %) i plazmafereza (9,10). Najnovija istraživanja pokazala su da tonzilektomija može imati povoljan efekat (11).…”

“…Ukoliko antibiotska terapija ne rezultira poboljšanjem, primjenjuju se imunoglobulini, kortikosteroidi, plazmafereza. Nova istraživanja su pokazala da tonzilektomija može imati povoljan učinak na smanjenje simptoma bolesti (11).…”