Ketheesan Sarangan, Wade Vicki, Hung Te-Yu, Roberts Kathryn V
Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
National Centre for Youth Substance Use Research, The University of Queensland, Herston, QLD, Australia.
Australas Psychiatry. 2025 Aug;33(4):619-622. doi: 10.1177/10398562251351462. Epub 2025 Jun 17.
ObjectiveWe highlight two autoimmune neuropsychiatric sequelae of group A streptococcal (GAS) infection that may cause disproportionate levels of psychiatric morbidity in Aboriginal and Torres Strait Islander people: Sydenham's Chorea (SC) and Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). GAS infections, along with better characterised immune-mediated sequelae such as acute rheumatic fever and rheumatic heart disease, are highly prevalent in Aboriginal and Torres Strait Islander people, particularly in rural and remote communities, yet there is minimal information in the literature about the neuropsychiatric sequelae that might be expected. We suspect that there is an under-recognised burden of disease in these groups and seek to understand reasons for this.ConclusionsA multi-faceted, culturally attuned approach to better characterising and detecting the burden of these two conditions in Aboriginal and Torres Strait Islander people is required. Furthermore, larger scale clinical trials examining the efficacy of proposed treatments for SC and PANDAS are required to inform clinical guidelines.
目的
我们着重介绍A组链球菌（GAS）感染的两种自身免疫性神经精神后遗症，它们可能在原住民和托雷斯海峡岛民中导致不成比例的精神疾病发病率： Sydenham舞蹈病（SC）和与链球菌感染相关的儿童自身免疫性神经精神疾病（PANDAS）。GAS感染，以及诸如急性风湿热和风湿性心脏病等特征更明确的免疫介导后遗症，在原住民和托雷斯海峡岛民中高度流行，尤其是在农村和偏远社区，但文献中关于可能出现的神经精神后遗症的信息极少。我们怀疑这些群体中存在未被充分认识的疾病负担，并试图了解其原因。
结论
需要采取多方面、符合文化特点的方法，以更好地描述和检测原住民和托雷斯海峡岛民中这两种疾病的负担。此外，需要进行更大规模的临床试验，以检验针对SC和PANDAS的拟议治疗方法的疗效，为临床指南提供依据。
