PPN Facebook PPN Twitter PPN Instagram

Commentaries

Reference Findings/ Critique
[Garvey1998] PANDAS: the search for environmental triggers of pediatric neuropsychiatric disorders. Lessons from rheumatic fever (commentary). Author reflects on the historical controversy on the relationship of GABHS and Acute Rheumatic Fever that was finally addressed with epidemiologic studies showing a sharp drop off in ARF when antibiotics were given for GABHS.
[Kurlan1998] Tourette’s syndrome and ‘PANDAS’: will the relation bear out? Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. (review) Review explores literature to date (1998) and advocates that well-designed and adequately controlled studies are needed to determine whether there is a true etiologic relation between streptococcal infection and the onset or exacerbation of childhood neuropsychiatric disorders. In addition, review advocates caution on immune-modifying therapies until addition research shows that such procedures are warranted.
[Singer2003] PANDAS: a commentary. (commentary/position paper) Argues that evidence is insufficient to treat PANDAS as a distinct entity and more research is needed.
[Kurlan2004a] The PANDAS hypothesis: losing its bite? (commentary) Argues that the diagnostic criteria for PANDAS are 1) not specific enough to distinguish PANDAS from typical presentation of Tourette’s syndrome, and 2) not validated by prospective longitudinal studies.  See [Swedo2004] for the response.
[Kurlan2004b] The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) etiology for tics and obsessive-compulsive symptoms: hypothesis or entity? Practical considerations for the clinician. (position paper) Argues that current evidence on PANDAS diagnosis is insufficient to warrant1) routine microbiologic or serologic testing for group A streptococcus in children who present with neuropsychiatric symptoms or 2) the clinical use of antibiotic or immune-modifying therapies in such patients
[Swedo2004] The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. (response) Response to [Kulan2004b] to clarify episodic course and clinical presentation. Comments that physical workup should include throat culture and positive culture should be treated per existing ADMA guidelines.
[Murphy2010] The immunobiology of Tourette’s disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders: a way forward. (review)Review explores evidence regarding the immunobiology as well as the relevant clinical and therapeutic aspects of TD, OCD, and PANDAS
[Singer2012] Moving from PANDAS to CANS (position paper)Authors split off from PANS paper and recommend creation of a new diagnosis that would use a first criteria of Obsessive Compulsive Disorder withacute, fulminant onset in childhood. Other symptom criteria are similar to PANS. Criteria would encompass a variety of conditions (infectious, post-infectious, drug-induced, toxic, traumatic,vascular, autoimmune, hypoxic, psychogenic).
[Macerollo2013] Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): an evolving concept (review) summarizes recent literature and compares the diagnostic criteria of PANDAS, PANS, and CANS.