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- Title
Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Beta-Haemolytic Streptococcal Infection: An Indication for Tonsillectomy? A Review of the Literature.
- Authors
Rajgor, Amarkumar Dhirajlal; Hakim, Navid Akhtar; Ali, Sanah; Darr, Adnan
- Abstract
<italic>Background. </italic>Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS) is the acute onset of neuropsychiatric symptoms following group A beta-haemolytic streptococcal infection. The aetiology remains elusive. However, with group A streptococcus being the most common bacterial cause of tonsillitis, surgical intervention in the form of tonsillectomy has often been considered as a potential therapy.<italic> Methods.</italic> A MEDLINE® search was undertaken using keywords “PANDAS” or “paediatric autoimmune neuropsychiatric disorders associated with streptococcus” combined with “tonsillectomy”.<italic> Results</italic>. Six case reports and 3 case series met the inclusion criteria. Demesh et al. (case series) reported a dramatic reduction in neuropsychiatric symptom severity in the patient cohort undergoing tonsillectomy. Two case series suggest that there is no association between tonsillectomy and resolution of PANDAS.<italic> Conclusion</italic>. Due to the lack of uniform data and sporadic reports, tonsillectomy should be carefully adopted for the treatment of this disorder. In particular, tonsillectomies/adenoidectomies to alleviate neuropsychiatric symptoms should be avoided until more definitive evidence is at our disposal. This review highlights the importance of a potential collaborative prospective study.
- Subjects
NEUROBEHAVIORAL disorders; TONSILLECTOMY; ADENOIDECTOMY; NEUROPSYCHIATRY; CHILD patients; THERAPEUTICS
- Publication
International Journal of Otolaryngology, 2018, p1
- ISSN
1687-9201
- Publication type
Article
- DOI
10.1155/2018/2681304