Hostname: page-component-77c89778f8-7drxs Total loading time: 0 Render date: 2024-07-16T10:17:05.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Investigating Tourette Syndrome as a Neurologic Sequela of Rheumatic Fever

Published online by Cambridge University Press:  07 November 2014

Roger Kurlan
Get access Rights & Permissions [Opens in a new window]

Abstract

Sydenham's chorea is currently recognized as the only neurologic sequela of rheumatic fever. Recent evidence suggests that there may be a spectrum of neurobehavioral disturbances, particularly including tics and obsessive-compulsive disorder, that develops following streptococcal infection by the process of molecular mimicry, whereby antibodies directed against bacterial antigens cross-react with brain targets. This proposed postinfectious, immune-mediated condition has been termed “pediatric autoimmune neuropsychiatric disorders after streptococcal infection” (PANDAS). This article reviews research evidence in favor and also against the PANDAS concept and discusses the implications of the hypothesis.

Type
Feature Articles
Information
CNS Spectrums , Volume 4 , Issue 2: Tourette Syndrome: Part One , February 1999 , pp. 62 - 67
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Markowitz, M, Kaplan, EL. Reappearance of rheumatic fever. Adv Pediatr. 1989;36:39–68.CrossRefGoogle ScholarPubMed
2.Veasy, LG, Tani, LY, Hill, HR. Persistence of acute rheumatic fever in the intermountain region of the United States. J Pediatr. 1994;124:9–11.CrossRefGoogle ScholarPubMed
3.Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association. Guidelines for the diagnosis of rheumatic fever. JAMA. 1992;268:2069–2073.CrossRefGoogle Scholar
4.Siegal, AC, Johnson, EE, Stollerman, EH. Controlled studies of streptococcal pharyngitis in a pediatric population. N Engl J Med. 1961;265:559–566.CrossRefGoogle Scholar
5.Rammelkamp, CH Jr, Stolzer, BL. The latent period before the onset of acute rheumatic fever. Yale J Biol Med. 1961;34:386–398.Google ScholarPubMed
6.Denny, FW, Wannamaker, LW, Brink, WR. Prevention of rheumatic fever treatment of the preceding streptococcic infection. JAMA. 1950;143:151–153.CrossRefGoogle ScholarPubMed
7.Chamovitz, R, Catanzaro, FJ, Stetson, CA, Rammelkamp, CH. Prevention of rheumatic fever by treatment of previous streptococcal infections. N Engl J Med. 1954;51:466–471.CrossRefGoogle Scholar
8.Cairns, LM. Immunologic studies in acute rheumatic fever. N Z Med J. 1988;101:388–391.Google Scholar
9.Stollerman, GH. Rheumatogenic streptococci and autoimmunity. Clin Immunol Immunopathol. 1991;61:131–142.CrossRefGoogle ScholarPubMed
10.Gordis, L. Effectiveness of comprehensive care programs in preventing rheumatic fever. N Engl J Med. 1973;89:331–335.CrossRefGoogle Scholar
11.Majeed, HA, Yousof, AM, Rotta, J. Group A streptococcal strains in Kuwait: a nine year prospective study of the prevalence and associations. Pediatr Infect Dis J. 1992;11:295–300.CrossRefGoogle Scholar
12.Nausieda, PA, Grossman, BJ, Roller, WC. Sydenham's chorea: an update. Neurology. 1980;30:331–334.CrossRefGoogle ScholarPubMed
13.Swedo, SE, Leonard, HL, Kiessling, LS. Speculations on antineuronal antibody-mediated neuropsychiatric disorders of childhood. Pediatrics. 1994;93:323–326.CrossRefGoogle ScholarPubMed
14.Swedo, SE, Leonard, HL, Mittleman, BB, et al.Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever. Am J Psychiatry. 1997;154:110–112.Google ScholarPubMed
15.Swedo, SE, Leonard, HL, Garvey, M, et al.Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998;155:264–271.CrossRefGoogle ScholarPubMed
16.Kondo, K, Kabasawa, T. Improvement in Gilles de la Tourette syndrome after corticosteroid therapy. Ann Neurol. 1978;4:387.CrossRefGoogle ScholarPubMed
17.Matarazzo, EB. Tourette's syndrome treated with ACTH and prednisone: report of two cases. J Child Adolesc Psychopharmacol. 1992;2:215–226.CrossRefGoogle ScholarPubMed
18.Kiessling, LS, Marcotte, AC, Culpepper, L. Antineuronal antibodies in movement disorders. Pediatrics. 1993;92:39–43.CrossRefGoogle ScholarPubMed
19.Husby, G, van de Rijn, I, Zabriskie, JB, Abdin, ZH, Williams, RC. Antibodies reacting with cytoplasm of subthalamic and caudate nuclei neurons in chorea and acute rheumatic fever. J Exp Med. 1976;144:1094–1110.CrossRefGoogle ScholarPubMed
20.Singer, HS, Giuliano, JD, Hansen, BH, et al.Increased antibodies against a neuroblastoma cell in children with Tourette's syndrome. Neurology. In press.Google Scholar
21.Singer, HS, Giuliano, JD, Hansen, BH, et al.Antibodies against human putamen in Tourette's syndrome. Neurology. 1998;50:1618–1624.CrossRefGoogle Scholar
22.Bruun, RD, Budman, CL. The natural course of Gilles de la Tourette syndrome. In: Kurlan, R, ed. The Handbook of Tourette's Syndrome and Related Tic and Behavioral Disorders. New York, NY: Marcel Dekker, 1993;27–42.Google Scholar
23.Klawans, HL, Barr, A. Recurrence of childhood multiple tic in late adult life. Arch Neurol. 1985;42:1079–1080.CrossRefGoogle ScholarPubMed
24.Phillips, S, Hogg, J, Kurth, M, Green, J. A resurgence of Sydenham's chorea in children in West Texas with atypical presentations. Neurology. 1992;42(suppl 3):288.Google Scholar
25.Swedo, SE, Rapoport, JL, Cheslow, DL, et al.High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. Am J Psychiatry. 1989;146:246–249.Google ScholarPubMed
26.Swedo, SE, Leonard, HL, Schapiro, MB, et al.Sydenham's chorea: physical and psychological symptoms of St. Vitus dance. Pediatrics. 1993;91:706–713.Google ScholarPubMed
27.Allen, AJ, Leonard, HL, Swedo, SE. Case study: a new infection-triggered, autoimmune subtype of pediatric OCD and Tourette's syndrome. J Am Acad Child Adolesc Psychiatry. 1995;4:307–311.CrossRefGoogle Scholar
28.Kiessling, LS, Marcotte, AC, Culpepper, L. Antineuronal antibodies: tics and obsessive-compulsive symptoms. J Dev Behav Pediatr. 1994;15:421–425.CrossRefGoogle ScholarPubMed
29.Tucker, DM, Leckman, JF, Scahill, L, et al.A putative poststreptococcal case of OCD with chronic tic disorder, not otherwise specified. J Am Acad Child Adolesc Psychiatry. 1996;35:1684–1691.CrossRefGoogle Scholar
30.Gibofsky, A, Khanna, A, Suh, E, Zabriskie, JB. The genetics of rheumatic fever relationship to streptococcal infection and autoimmune disease. J Rheumatol. 1991;18(suppl 30):1–5.Google Scholar
31.Murphy, TK, Goodman, WK, Fudge, MW, Williams, RC, Ayoub, EM, Dalai, M, et al.β lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive compulsive disorder and Tourette's syndrome? Am J Psychiatry. 1997;154:402–407.Google Scholar
32.Trifiletti, RR, Altemus, M, Zabriskie, J. TS83: candidate target autoantigen in Tourette syndrome and OCD. Biol Psychiatry. 1998;43:725.CrossRefGoogle Scholar
33.Mittleman, BB, Castellanos, FX, Jacobsen, LK, Rapoport, JL, Swedo, SE, Shearer, GM. Cerebrospinal fluid cytokines in pediatric neuropsychiatric disease. J Immunol. 1997;159:2994–2999.CrossRefGoogle ScholarPubMed
34.Kurlan, R. Tourette's syndrome and PANDAS: will the relation bear out? Neurology. 1998;50:1530–1534.CrossRefGoogle ScholarPubMed
35.Mercadante, MT, Campos, MC, Marques-Dias, MJ, Miguel, EC, Leckman, J. Vocal tics in Sydenham's chorea. J Am Acad Child Adolesc Psychiatry. 1997;36:305–306.CrossRefGoogle ScholarPubMed
36.Cardoso, F, Eduardo, C, Silva, AP, Mota, CC. Chorea in fifty consecutive patients with rheumatic fever. Mov Disord. 1997;12:701–703.CrossRefGoogle ScholarPubMed
37.DeCunto, CL, Giannini, EH, Fink, CW, Brewer, EJ, Person, DA. Prognosis of children with streptococcal reactive arthritis. Pediatr Infect Dis. 1988;7:683–686.CrossRefGoogle Scholar
38.Arnold, MH, Tyndall, A. Poststreptococcal reactive arthritis. Ann Rheum Dis. 1989;48:686–688.CrossRefGoogle ScholarPubMed
39.Kaplan, EL, Gerber, MA. Group A, group C and group G beta-hemolytic streptococcal infections. In: Feigin, RD, Cherry, JD, eds. Textbook of Pediatric Infectious Disease. 4th ed. Philadelphia, Pa: WB Saunders; 1988;1076–1088.Google Scholar