New Article ~ PANDAS/Strep & Lyme

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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 Rhee1, J Cameron2

1Medicine, San Diego, CA, 2Northern 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.

= = = =

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