Neuropsychıatrıc dısorders assocıated wıth chıldhood ımmunologıc dysfunctıon

Abstract

Introduction. These disease entities are known as pediatric neuropsychiatric syndromes because infectious pathogens other than streptococci have also been reported to be associated with neuropsychiatric symptoms. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS).

Aim. The aim of this study was to evaluate neuropsychiatric disorders associated with immunologic dysfunction in childhood.

Overview. PANS/PANDAS refers to the acute and dramatic onset of a neuropsychiatric syndrome in children, including OCD and/or tics. It is believed to be the result of an autoimmune reaction to the basal ganglia nuclei, initiated by infection with group A streptococci. Studies indicate neuroinflammatory reactions in the basal ganglia and related networks.

Conclusions. Evaluating treatment strategies for PANS/PANDAS remains a challenge because it is a rare disease with few published high-quality studies. Little is known about its etiology, diagnostic methods, treatments or long-term effects. However, as hundreds of children and families suffer from the debilitating effects of the disease, infectious diseases should be carefully evaluated for PANS/PANDAS, especially in the pediatric age group. Even in the absence of evidence on which to base interventions, it is within the scope of advanced nursing practice to provide psychotherapeutic care with an empathetic perspective to children and families struggling with the frustration, fear and anxiety caused by illness.