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Am J Psychiatry 1997; 154:110-112
Copyright © 1997 by American Psychiatric Association
Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever
SE Swedo, HL Leonard, BB Mittleman, AJ Allen, JL Rapoport, SP Dow, ME Kanter, F Chapman and J Zabriskie
Section on Behavioral Pediatrics, Child Psychiatry Branch, NIMH, Bethesda, MD 20892-1381, USA.
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.
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