pdf: Lyme disease and PANDAS

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Lyme disease and pediatric autoimmune neuropsychiatric disorders

associated with streptococcal infections (PANDAS): an overview

http://www.dovepress.com/lyme-disease-and-pediatric-autoimmune-neuropsychiatric-\

disorders-assoc-peer-reviewed-article-IJGM

Hanna Rhee^1 , J Cameron^2

^1 Medicine, San Diego, CA, ^2 Northern Westchester Hospital, Mount

Kisco, NY, USA

Lyme disease (LD) is a complex, multisystemic illness. As the most

common vector-borne disease in the United States, LD is caused by

bacterial spirochete /Borrelia burgdorferi/ sensu stricto, with

potential coinfections from agents of anaplasmosis, babesiosis, and

ehrlichiosis. Persistent symptoms and clinical signs reflect multiorgan

involvement with episodes of active disease and periods of remission,

not sparing the coveted central nervous system. The capability of

microorganisms to cause and exacerbate various neuropsychiatric

pathology is also seen in pediatric autoimmune neuropsychiatric

disorders associated with streptococcal infections (PANDAS), a recently

described disorder attributed to bacterium /Streptococcus pyogenes/ of

group A beta-hemolytic streptococcus in which neurologic tics and

obsessive-compulsive disorders are sequelae of the infection. In the

current overview, LD and PANDAS are juxtaposed through a review of their

respective infectious etiologies, clinical presentations, mechanisms of

disease development, courses of illness, and treatment options. Future

directions related to immunoneuropsychiatry are also discussed.

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*Researchers Publish Long Awaited Lyme Disease and PANDAS Review Despite

Controversies*

http://www.prnewswire.com/news-releases/researchers-publish-long-awaited-lyme-di\

sease-and-pandas-review-despite-controversies-140052803.html

SAN DIEGO, Feb. 22, 2012 /PRNewswire-iReach/ -- Neurologic tics and

obsessive-compulsive behaviors caused by a bacterial infection in

children were once thought to occur exclusively in PANDAS (Pediatric

Autoimmune Disease Associated with Streptococcus infections). Despite

ongoing controversies regarding Lyme disease and PANDAS, a recent

evidence-based review by J. Cameron, MD, MPH and Hanna Rhee, MD

uncovered a little known published report of a child who initially

appeared to have PANDAS, but was later found to have Lyme disease. When

the patient was treated with antibiotics for the bacterial infection

transmitted by a tick bite, his symptoms resolved.

" Our extensive review of the literature has elucidated the mechanism

with which a tick bite or sore throat may develop into neuropsychiatric

disorders. TLRs (Toll-like receptors) in haplotype-variable individuals

may play a role in multisystemic disease formation, " states Dr. Rhee.

" We chose to publish our review paper in the International Journal of

General Medicine, an online publication which provides open access to

the public so that families and their physicians can download a free

copy to reference at their convenience. In the context of psychiatric

pathology, maintaining a differential diagnosis inclusive of an

infectious etiology is what may help to save that child's life, " reports

co-author Dr. Cameron.*

*

Media Contact*:*Hanna Rhee Hanna Rhee, MD Inc, ,

hannarhee@...

SOURCE Hanna Rhee, MD Inc