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Basic and Clinical Neuroscience، جلد ۶، شماره ۱، صفحات ۳۸-۴۳
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| عنوان فارسی |
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| چکیده فارسی مقاله |
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| کلیدواژههای فارسی مقاله |
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| عنوان انگلیسی |
Group A β-hemolytic Streptococcal Infection in Children and the Resultant Neuro-psychiatric Disorder a Cross Sectional Study Tehran, Iran |
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| چکیده انگلیسی مقاله |
Introduction: Group A Beta-Hemolytic Streptococcus (GABHS) can induce PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection). GABHS is the most important and common bacterial cause of acute pharyngitis in Iranian children. We studied the role of GABHS (anti-streptococcal antibodies) in suspected cases of PANDAS in a cross sectional studies. Methods: Across sectional study was done in 2 pediatric psychiatric /and neurologic clinics in Tehran (Rasul Akram and Aliasghar Hospital) during 2008-2010. We studied serum antistreptococcal antibodies (anti streptolysin O, anti Deoxyribonuclease B, and anti-streptokinase (ABcam-ELISA, USA) in 76 cases with psychiatric manifestation (OCD, ADHD) in compare with 39 healthy controls. These antibodies were studied in 53 cases with movement disorders (Tic/ Tourette syndrome ) in compare with 76 healthy controls. Sensitivity, specificity and positive predictive value of tests were calculated. Results: In movement disorders ASOT, Anti-DNase and Anti streptokinase was significantly higher than controls (p< 0.0001, p=0.000, p< 0.00001) ASOT (cut off level> 200IU/ml) had 75% sensitivity 84% specificity and 80% PPV Antistreptokinase (cut off level> 332 IU/ml) had 34% sensitivity 85% specificity, and 72% PPV Anti-DNase (cut off level> 140IU/ml) had 70% sensitivity 99% specificity and PPV 90% for differentiating the group. ASOT, Anti-DNase and Anti streptokinase titer was significantly higher than controls (p< 0.0001, p=0.000, p< 0.0001). ASOT had 90% sensitivity 82% specificity, PPV 92% Anti streptokinase: 82% sensitivity 82% specificity, PPV 95% Anti DNase: 92% sensitivity 82% specificity, PPV 92% for differentiation the cases from normal controls. Discussion: These findings support that a post infectious immune mechanism to GABHS may play a role in the pathogenesis of PANDAS in our children. A combination of throat culture, rapid antigen detection test, and serologic testing for GABHS is required to achieve maximum sensitivity and specificity for diagnosis. We prefer to use antibiotic prophylaxis in PANDAS cases for preventing recurrent streptococcal infections. Ongoing research is needed for identifying optimum diagnostic, prevention and therapeutic approach especially, aggressive treatment (intravenous immunoglobulin, plasmaphresis). |
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| کلیدواژههای انگلیسی مقاله |
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| نویسندگان مقاله |
فریده ابراهیمی تاج | farideh ebrahimi taj
research center of pediatric infectious diseases, 4th floor
ثمیله نوربخش | samileh noorbakhsh
research center of pediatric infectious diseases, 4th floor
سحر قویدل دارستانی | sahar ghavidel darestani
research center of pediatric infectious diseases, 4th floor
الهام شیرازی | elham shirazi
research center of pediatric infectious diseases, 4th floor
شیما جوادی نیا | shima javadinia
research center of pediatric infectious diseases, 4th floor
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| نشانی اینترنتی |
http://bcn.iums.ac.ir/browse.php?a_code=A-10-200-3&slc_lang=en&sid=en |
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| کد مقاله (doi) |
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| زبان مقاله منتشر شده |
en |
| موضوعات مقاله منتشر شده |
Clinical Neuroscience |
| نوع مقاله منتشر شده |
Original |
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