A possible association of recurrent streptococcal infections and acute onset of obsessive-compulsive disorder

The Journal of Neuropsychiatry and Clinical Neurosciences
Suck Won KimPatrick M Schlievert

Abstract

Rheumatic fever is an immunologically mediated disease that follows infection by group A beta-hemolytic Streptococcus (GABHS). In rheumatic fever, antibodies generated against GABHS cross-react with the heart, joints, skin, and other sites, inducing an inflammatory, multisystem disease. Brain tissue-specific antibodies have been demonstrated in a subset of children with Sydenham chorea (a component of the Jones criteria for the diagnosis of rheumatic fever), and most Sydenham chorea patients manifest obsessive-compulsive symptoms very similar to those in traditional obsessive-compulsive disorder. The parallels drawn from the paradigm of Sydenham's chorea to Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is an area of active controversy. Newly emerging information on the role of GABHS superantigens in the pathogenesis of rheumatic fever is of particular interest. In this article, we review the microbial characteristics of GABHS and the subsequent immune responses to GABHS as a possible etiology of PANDAS.

Citations

May 23, 2008·Clinical Practice and Epidemiology in Mental Health : CP & EMH·Germana MorettiMassimo Biondi
Jul 5, 2013·Clinical Microbiology Reviews·Adam R SpauldingPatrick M Schlievert
Aug 5, 2010·Pediatric Neurology·Daniëlla M OosterveerRaymund A C Roos
May 10, 2006·Advances in Immunology·Betty DiamondBruce T Volpe
May 4, 2011·The FEBS Journal·Amanda J Brosnahan, Patrick M Schlievert
Apr 1, 2007·Acta Neuropsychiatrica· Ashfaq-U-RahamanPramod Kumar Pal

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