Orvidas L J, Slattery M J
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Laryngoscope. 2001 Sep;111(9):1515-9. doi: 10.1097/00005537-200109000-00005.
To increase awareness and understanding of the putative role of streptococcal infection in the development of neuropsychiatric disorders in children and to discuss therapeutic options in this group of patients.
Case illustration and literature review.
Two siblings, one with obsessive-compulsive disorder (OCD) and one with a tic disorder, had tonsillectomy for recurrent streptococcal pharyngitis. At the latest follow-up visit (11 mo postoperatively), both patients exhibited significant improvement in their psychiatric illnesses. We discuss these cases as well as the diagnosis, pathophysiology, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
PANDAS is an active area of research investigating the relationship between streptococcal infections and the development of obsessive-compulsive disorder or tic disorders (or both) in children. The etiopathogenesis of PANDAS is thought to reflect autoimmune mechanisms and involvement of the basal ganglia of susceptible hosts. Because otolaryngologists evaluate a large portion of pediatric patients with recurrent streptococcal pharyngitis, it is important to be aware of this association and to manage these patients appropriately.
提高对链球菌感染在儿童神经精神障碍发生中假定作用的认识和理解，并探讨该组患者的治疗选择。
病例说明与文献综述。
两名兄弟姐妹，一名患有强迫症（OCD），另一名患有抽动障碍，因复发性链球菌性咽炎接受了扁桃体切除术。在最近的随访（术后11个月）中，两名患者的精神疾病均有显著改善。我们讨论了这些病例以及与链球菌感染相关的儿童自身免疫性神经精神障碍（PANDAS）的诊断、病理生理学和治疗。
PANDAS是一个正在积极研究链球菌感染与儿童强迫症或抽动障碍（或两者）发生之间关系的领域。PANDAS的病因发病机制被认为反映了自身免疫机制以及易感宿主基底神经节的受累情况。由于耳鼻喉科医生会评估很大一部分复发性链球菌性咽炎的儿科患者，因此了解这种关联并对这些患者进行适当管理非常重要。
