Strep infection doesn't worsen childhood tics or OCD symptoms
by Will Boggs, MD
2008-06-16 13:29:56 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Streptococcal infection does not cause exacerbations of childhood tics or obsessive-compulsive symptoms, according to a report in the June issue of Pediatrics.
"This study provides further evidence against the use of chronic antibiotic or immune-suppressing therapy to treat these patients, as has been suggested," Dr. Roger Kurlan from University of Rochester School of Medicine, New York told Reuters Health.
"Patients meeting criteria for PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) seem to do fine with standard treatments for their symptoms of tics or obsessive-compulsive disorder (OCD)."
Dr. Kurlan and colleagues sought to determine whether there is a bona fide relationship between antecedent group A beta-hemolytic streptococcal (GABHS) infection and exacerbation of symptoms in 40 children who met the published diagnostic criteria for PANDAS, which included a temporal relationship between the course of illness and GABHS infection. These children were matched with 40 controls, who had OCD or a chronic tic.
Sixty-five clinical exacerbations occurred during the study; of these, 40 episodes occurred in 21 PANDAS children and 25 episodes were seen in 14 control children, the authors report, resulting in exacerbation rates of 0.56 per person-year for PANDAS children and 0.28 per person-year for control subjects.
PANDAS children, however, had more than three-times the GABHS infection rate than control children (0.43 versus 0.13 per person-year), the report indicates, and the higher risk of clinical exacerbation of tics or OCD for PANDAS children did not reach statistical significance.
Only 5 of the 64 total clinical exacerbations of tics and/or OCD occurred within 4 weeks of GABHS infection, and all 5 occurred in PANDAS subjects.
Based on a variety of time intervals and infection classifications, 75% to 92.5% of exacerbations in PANDAS children occurred with no observed evidence of a temporal relationship to GABHS infection, the investigators say.
"Our study results must be interpreted with caution," the researchers note, "because the number of clinical exacerbations and the number of GABHS infections observed were smaller than originally anticipated, particularly in control subjects."
"The most surprising result was that for children meeting criteria for PANDAS, so few of their exacerbations were linked to strep infection," Dr. Kurlan said.
"It remains unclear if the PANDAS hypothesis is true as presented," Dr. Kurlan concluded. In another trial the investigators "found no evidence of immune factors in association with clinical exacerbations in PANDAS cases, casting doubt on the autoimmune hypothesis."
Pediatrics 2008;121:1188-1197.
Copyright Reuters 2008.
This research is very interesting but doesn't convince me of no link. Obviously there IS a link in my own home and with the myriad of children I read about and see with my own eyes day after day in elementary classrooms. My children also do not meet the exact description of PANDAS as outlined by the Am. Academy of Pediatrics. Funny though, I thought the AAP didn't agree to a diagnostic criteria for PANDAS, referring to it only as a theory. Now in this publishing they refer to a criteria. Makes you wonder what is going on here. Bottom line is there are atypical responses to strep too numerous to ignore. Autoimmune reactions to strep, 5ths disease, Lyme, and many other illnesses is very disturbing and warrant immediate funding and attention. This is the future and it's obviously not going away.
I've written more posts on this topic. Also go to my Labels on the right and click on P.A.N.D.A.S. or strep.
12 comments:
I know a child who met the criteria for PANDAS (through blood work and symptoms) and the doctor put him on Penicillin. The mother just took him off of it because it was making his tics (and his OCD) much worse. Now she needs to find a doctor who will do IVIG.
In the meantime, do you know of any supplements/natural treaments that would help the immune system and PANDAS?
That's interesting that a ped is still using antibiotics when the protocol doesn't recommend it. Poor kid!
There are many immune boosters that may work depending on the child. High doses of garlic (pills, drops, and cooking it) have been very effective in boosting wellness. A gluten-free diet with very little processed foods is key even though allergies may not be present. 85% of people have a gluten sensitivity, most people don't even know it. I see whenever we go off the wagon like we did on vacation this summer, tics and wellness go down.
Kefir, a powerful probiotic along with other acidophilis pills is helpful. Omegas, vitamins D and B. Elderberry, red sea algae, olive leaf extract, berberry. Also I have found digestive enzymes taken daily helps assimilate food, but as a side improves wellness. Probably because their GI system is supported.
Hope this helps!
He is very high functioning but has many tics and OCD behaviors. The doctor who put him on Penicllin is an Immunologist out of a major hospital that doesn't even believe PANDAS exists so I told her to go to a good DAN doctor who knows what they are doing. I know the child is on a strict GF/CF diet. His G/I problems are still an issue and the current G/I doctor he sees just, of course, keeps uping the dose of Prevacid. Just covering up the problem I told the mom. She's not sure about the IVIG. That is a risk but she may do it.
So interesting. I don't know much about IVIG. Sounds pretty intense. I would probably focus on less invasive treatments such as nutrition and supplements FIRST, perhaps other DAN options like you suggested already. Even the hyperberic chamber. So many issues tie back to lack of oxygen in neurological disorders.
Good to know that gluten isn't a problem. Also, homeopathy is an amazing alternative as well. There are several OCD remedies out there like Stramonium which really work for many kids.
Homeopathy works on a physics level rather than biological, so it doesn't interfere with other bio treatments. recoveredfromautism.com is where I'd go if your person wants to investigate further. And it's cheap, $7 for a remedy.
Poor thing probably just needs to take a break from meds and stabilize a bit. I'm not against meds in general, just against meds that don't work or are not used to address the root of a problem.
He was on too many meds which the mother now knows screwed him up even further. She is just getting into biomedical but is with all the wrong doctors. Hopefully she'll find a good one. Also, it sounds like he has major yeast issues. Not sure if she is addressing that and she does need to do some sort of toxin removal.
Hopefully she'll get on a better path soon. I hear ya on the yeast - impossible to NOT have a yeast problem with numerous meds. That's why Kefir/probiotics and supplements that change pH like garlic should make a big diff.
Do you have a website anon? We seem so much on the same page I'd be interested in learning/reading your blog.
Thanks for the info. We did an all-natural treatment for our son too and have had tremendous success. We did not get the PANDAS dx even though the initial onset looked like it could be PANDAS. Our son was dxd with a chronic multifocal tic disorder. We are on a strict gluten and corn free diet and we are organic, too. We use supplements too and he is generally symptom free now. We will see flair ups when he is exposed to his allergens or when he is under tremendous stress, but it is rare and the symptoms are almost unnoticeable now, compared to how he was before we made the changes. I am a green mom now as a result, and I love what you are doing here! I am going to bookmark this site because you offer loads of info on environmental and health issues that are important to us. Thanks again!
Thanks Peeps.
I stumbled upon your blog while searching for items relating to PANDAS. Just wanted to let you know there is a great forum over at www.latitudes.org if you are interested. My daughter was finally diagnosed with PANDAS after many years of various other wrong diagnoses.
Hugs,
Manda
Thanks Amanda. I think I've been to that site before, thanks!
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