Objectives:
- To study the association between neuropsychiatry morbidity and streptococcal infections.
- 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.
Key words: ASO and ADNB, Neuropsychiatric morbidity, PANDAS, Streptococcal infections
