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What is Pandas disease?
It is a neuropsychiatric disease caused by streptococci in children. Information about the incidence of the disease is insufficient. PANDAS disease was first described in 1998. It is a little-known disease.
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What are the characteristics of PANDAS symptoms?
The most typical feature of the disease is the sudden onset. The disease flares up from time to time.
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What are the symptoms of PANDAS?
The symptoms indicate streptococcal infection. It starts after the following 4 to 6 weeks. It is observed that the symptoms intensify and reach serious levels within two to three days.
Obsessive compulsive disorders (obsession) are typical in children. Patients are timid and distressed. They have fears. They don't want to go to school. They hallucinate. Tics and involuntary movements are observed. Their sleep is irregular. There is a significant decrease in their academic success.
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Hyperactivity
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Urinary incontinence
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Deterioration in handwriting
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Extreme sensitivity
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Withdrawal from society
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There may be joint pain.
Not all of these symptoms may be seen in PANDAS. Usually, multiple physical and psychiatric symptoms are present together.
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What causes PANDAS disease?
What causes the disease? There is only one microorganism. The causative agent is group A beta hemolytic streptococcus. When the patient encounters this infection, the immune system creates protective substances against the microbe. These substances, which we define as antibodies, instead of clearing the beta microbe from the body in these patients, go to the brain and settle in the part of the brain we define as the basal ganglia, causing neuropsychiatric symptoms.
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Who is at risk of PANDAS disease?
The condition may develop in children and teenagers between the ages of 3 and 12 who had a streptococcal infection four to six weeks ago.
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Recurrent infections
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Genetic factors
Other risk factors.
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How is PANDAS diagnosed?
Pediatricians have a great role in the diagnosis of this disease. A careful history, physical examination and laboratory examination should be performed.
Throat culture
ASO, Anti-Dnase B activity should be examined periodically.
Cranial MRI should be performed.
PANDAS TREATMENT
It can be examined under two headings.
Antibiotics are administered for the treatment of streptococcus. Patients need to be monitored to prevent recurrent infections. Serological examinations should be performed.
The treatment approach planned by the psychiatrist should be relative.
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PANDAS is difficult to treat
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There are treatment alternatives.
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In severe cases, Plasmapheresis and / or Immunoglobulins (IVIG) can be applied.
PANDAS is a serious clinical condition.
In cases where the diagnosis is made late, chronicity may occur.
Children and young people with sudden-onset obsessive compulsive disorder and tics can also be diagnosed. PANDAS should be considered.
It should not be forgotten that PANDAS is an important and treatable disease.
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