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每位精神科医生都应了解的儿童自身免疫性神经精神障碍相关链球菌感染（PANDAS）：综述

What every psychiatrist should know about PANDAS: a review.

作者信息

Moretti Germana, Pasquini Massimo, Mandarelli Gabriele, Tarsitani Lorenzo, Biondi Massimo

机构信息

Department of Psychiatric Sciences and Psychological Medicine, "Sapienza" University of Rome, Viale dell'Univeristà 30, 00185, Rome, Italy.

出版信息

Clin Pract Epidemiol Ment Health. 2008 May 21;4:13. doi: 10.1186/1745-0179-4-13.

DOI:10.1186/1745-0179-4-13
PMID:18495013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2413218/
Abstract

The term Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infections (PANDAS) was coined by Swedo et al. in 1998 to describe a subset of childhood obsessive-compulsive disorders (OCD) and tic disorders triggered by group-A beta-hemolytic Streptococcus pyogenes infection. Like adult OCD, PANDAS is associated with basal ganglia dysfunction. Other putative pathogenetic mechanisms of PANDAS include molecular mimicry and autoimmune-mediated altered neuronal signaling, involving calcium-calmodulin dependent protein (CaM) kinase II activity. Nonetheless the contrasting results from numerous studies provide no consensus on whether PANDAS should be considered as a specific nosological entity or simply a useful research framework. Herein we discuss available data that could provide insight into pathophysiology of adult OCD, or might explain cases of treatment-resistance. We also review the latest research findings on diagnostic and treatment.

摘要

“儿童自身免疫性神经精神障碍伴链球菌感染”（PANDAS）这一术语由斯韦多等人于1998年提出，用于描述由A组β溶血性化脓性链球菌感染引发的儿童强迫症（OCD）和抽动障碍的一个子集。与成人强迫症一样，PANDAS与基底神经节功能障碍有关。PANDAS的其他假定发病机制包括分子模拟和自身免疫介导的神经元信号改变，涉及钙调蛋白依赖性蛋白（CaM）激酶II活性。尽管如此，众多研究结果相互矛盾，对于PANDAS应被视为一种特定的疾病实体还是仅仅是一个有用的研究框架，尚未达成共识。在此，我们讨论现有数据，这些数据可能有助于深入了解成人强迫症的病理生理学，或解释治疗抵抗的病例。我们还回顾了诊断和治疗方面的最新研究结果。

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