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PANDAS

Sist revidert:
Sist revidert av:
Definisjon:
Pediatrisk autoimmun nevropsykiatrisk forstyrrelse assosiert med streptokokkinfeksjon. Omstridt tilstand
Forekomst:
Sjelden, men finnes hos barn i alderområdet 3 til 12 år
Symptomer:
Akutt sykdom med plutselig (1-2 dager) oppstått tvangslidelse eller tics med tidsmessig relasjon til GAS-infeksjon i typisk tilfelle
Funn:
Tvangstanker og tvangshandlinger, ev. motoriske og/eller vokale tics
Diagnostikk:
Klinisk diagnosen, men dokumentert forutgående streptokokkinfeksjon styrker mistanken
Behandling:
Kontroversiell og utilfredsstillende dokumentert. Antibiotika ved påvist GAS.
  1. Bejerot S, Bruno K, Gerland G, et al. Misstänk PANDAS hos barn med akuta neuropsykiatriska symptom. Läkartidningen 2013; 110: CDCD. PMID: 24187894 PubMed  
  2. Swedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry 1998; 155:264. American Journal of Psychiatry  
  3. Pichichero ME. PANDAS: Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci. UpToDate, last updated Apr 2022. Siden lest 09.02.2023 UpToDate  
  4. Gromark C, Harris RA, Wickström R, et al. Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet. J Child Adolesc Psychopharmacol. 2019 Jun 5. doi:10.1089/cap.2018.0127 DOI  
  5. Sørensen CB, Skov L, Lundby L, et al. PANDAS og PANS er fortsat omdiskuterede postinfektiøse autoimmune neuropsykiatriske sygdomme hos børn og unge. Ugeskr Laeger. 2018 Nov 26;180(48) . pmid:30518465 PubMed  
  6. Prato A, Gulisano M, Scerbo M, et al. Diagnostic Approach to Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS): A Narrative Review of Literature Data. Front Pediatr 2021; 9: 746639. pmid:34778136 PubMed  
  7. Kurlan R, Kaplan EL. The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) etiology for tics and obsessive-compulsive symptoms: hypothesis or entity? Practical considerations for the clinician. Pediatrics 2004; 113:883. Pediatrics  
  8. Shulman ST. Pediatric autoimmune neuropsychiatric disorders associated with streptococci (PANDAS): update. Curr Opin Pediatr 2009; 21:127. PubMed  
  9. Orlovska S, Vestergaard CH, Bech BH, et al. Association of Streptococcal Throat Infection With Mental Disorders: Testing Key Aspects of the PANDAS Hypothesis in a Nationwide Study. JAMA Psychiatry 2017; 74: 740. pmid:28538981 PubMed  
  10. Swedo SE, Leonard HL, Rapoport JL. The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. Pediatrics 2004; 113:907. Pediatrics  
  11. Gilbert DL, Mink JW, Singer HS. A Pediatric Neurology Perspective on Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute-Onset Neuropsychiatric Syndrome. J Pediatr 2018; 199: 243-51. pmid:29793872 PubMed  
  12. Sigra S, Hesselmark E, Bejerot S. Treatment of PANDAS and PANS: a systematic review. Neuroscience & Biobehavioral Reviews Volume 86, March 2018, Pages 51-65. doi.org  
  13. FHI. Forenklet metodevurdering. Behandling med intravenøs immunoglobulin ved PANS/PANDAS-tilstandene hos barn. Rapport - Folkehelseinstituttet 2021. www.fhi.no  
  14. Murphy ML, Pichichero ME. Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS). Arch Pediatr Adolesc Med 2002; 156:356. PubMed  
  • Ingard Løge, spesialist i allmennmedisin, redaktør NEL
  • Terje Johannessen, professor i allmennmedisin, Trondheim