A CASE CONTROL STUDY ON THE ASSOCIATION BETWEEN NEURO PSYCHIATRIC MORBIDITY AND STREPTOCOCCAL INFECTIONS IN CHILDREN
VISWANATHAN. S*, PRABHAKAR. D. MOSES**, SNEHA VAARKKI***, PAUL RUSSELL****, BRAHMADHATHAN*****, ELIZABETH MATHAI******
Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. *, Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. **, Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. ***, Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. ****, Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. *****, Departments of Child Health, Child & Adolescent Psychiatry, Clinical Microbiology, Christian Medical Collage & Hospital, Vellore - 632004, Tamilnadu, India. ******
Objectives
  1. To study the association between neuropsychiatry morbidity and streptococcal infections.
  2. To study the clinical profile of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) in children.
Design
Case control study.
Setting
Child health department of Christian Medical College, Vellore, a tertiary care hospital.
Subjects
22 children in the age group of 4 to 16 years visiting CMC Hospital, Vellore with Neuropsychiatric morbidity and 64 age and sex matched randomized controls.
Methods
Children with neuropsychiatric morbidity in the spectrum of PANDAS were investigated for evidence of streptococcal infection, namely Anti-Streptolysin O (ASO) and Anti-Deoxyribonuclease B (ADNB). 3 randomized age and sex matched controls were also taken for every case. The results were compared between cases and controls.
Results
ASO and ADNB positivity was more in cases than controls, which was statistically significant (p value = 0.026). Odd's ratio was 3.428 and 95% confidence interval was (1.15 to 10.18). None of the cases had major abnormality in lead, ceruloplasmin and antinuclear antibody (ANA).
Conclusion
There is a definite statistically significant association between neuropsychiatric morbidity and streptococcal infections in the age group of 4-16 years. This group of children could be followed up on long-term basis to prove a causal and temporal association with streptococcal infections and for diagnostic validation of PANDAS.
Keywords
ASO and ADNB, Neuropsychiatric morbidity, PANDAS, Streptococcal infections
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S V, MOSES D P, VAARKKI S, RUSSELL P, BRAHMADHATHAN, MATHAI E.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=28
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