OBJECTIVE: The authors' goal was to determine whether a trait marker of
rheumatic fever susceptibility (labeled D8/17) could identify children with
pediatric autoimmune neuropsychiatric disorders (obsessive- compulsive
disorder and tic disorders) associated with streptococcal infections
(PANDAS). METHOD: Blood samples obtained from 27 children with PANDAS, nine
children with Sydenham's chorea, and 24 healthy children were evaluated for
D8/17 reactivity. Individuals were defined as D8/17 positive if they had
12% or more D8/17+ cells. RESULTS: The frequency of D8/17-positive
individuals was significantly higher in both patient groups than it was
among the healthy volunteers: 85% of the children with PANDAS and 89% of
the children with Sydenham's chorea, compared with 17% of the healthy
children, were D8/17 positive. Further, the mean number of D8/17+ cells was
similar in the two patient groups and was significantly higher in these
groups than in the group of healthy children. CONCLUSIONS: These results
suggest that there may be a subgroup of D8/17-positive children who present
with clinical symptoms of obsessive-compulsive disorder and Tourette's
syndrome, rather than Sydenham's chorea, but who have similar
poststreptococcal autoimmunity.
Abstract Teaser