THE ROLE OF GROUP A BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN PATIENTS WITH TIC AND TOURETT'S DISORDERS

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NOORBAKHSH SAMILEH; JALILI BEHROOZ; SHAMSHIRI AHMAD REZA; SHIRAZI ELHAM; TABATABAEI AZARDOKHT; TAGHIPOUR REZA; MODARES FATHI AHMAD

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Journal: Tehran University Medical Journal Year:2010 | Volume:68 | Issue:9 Page(s): 534-540

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Title

THE ROLE OF GROUP A BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN PATIENTS WITH TIC AND TOURETT'S DISORDERS

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Keywords

GROUP A STREPTOCOCCUSQ3

PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTION (PANDAS)Q3

TIC DISORDERSQ3

TOURETT’S SYNDROMEQ3

Abstract

Background: Recently, many cases diagnosed as pediatric autoimmune neuropsychiatric disorders associated with group A beta hemolytic streptococcus infection (PANDAS) due to production of autoimmune antibodies. Object of this study was comparison the titer of antibodies against group A beta hemolytic streptococcus (ASOT, Anti-DNase B, and Anti streptokinase) between children with movement disorders (tic and tourett’s disorders; pediatric autoimmune psychiatric disorders) and healthy control.Methods: A cross sectional/ cases control study in pediatric neuropsychology ward and clinics in two referral hospitals (Rasoul & Aliasghar) affiliated by IUMS had done in Tehran, Iran (2008-2010). We selected 53 children with tic disorder and 76 healthy controls (age matched children). The antibody titers (IU/ml) in their area were compared and analyzed statistically. The area under ROC, sensitivity, specificity and positive predictive value of tests calculated.Results: Age of cases was between 4-16 years. All antibody titers had significant difference between two groups (p<0.0001; p=0.05; p=0.002 for ASOT, Anti-DNase and Antihyaloronidase respectively). ASOT (cut off level>200IU/ml) had 75% sensitivity; 84% specificity and 80% PPV; Anti- streptokinase (cut off level>332IU/ml) had 34% sensitivity; 85% specificity, and 90% PPV; Anti-DNase (cut off level>140IU/ml) had 70% sensitivity; 99% specificity and PPV 90%.Conclusion: Patients with tic disorder had a significant high antibody titer against streptococcal infection in comparison with healthy children. It presents possible role for streptococcal infection in TIC DISORDERS. Treatment of streptococcal infection is achievable by using of long acting Penicillin in our country. Use of aggressive treatment like plasmaphresis etc needs future RCT studies.

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APA: Copy

NOORBAKHSH, SAMILEH, JALILI, BEHROOZ, SHAMSHIRI, AHMAD REZA, SHIRAZI, ELHAM, TABATABAEI, AZARDOKHT, TAGHIPOUR, REZA, & MODARES FATHI, AHMAD. (2010). THE ROLE OF GROUP A BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN PATIENTS WITH TIC AND TOURETT'S DISORDERS. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), 68(9), 534-540. SID. https://sid.ir/paper/39565/en

Vancouver: Copy

NOORBAKHSH SAMILEH, JALILI BEHROOZ, SHAMSHIRI AHMAD REZA, SHIRAZI ELHAM, TABATABAEI AZARDOKHT, TAGHIPOUR REZA, MODARES FATHI AHMAD. THE ROLE OF GROUP A BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN PATIENTS WITH TIC AND TOURETT'S DISORDERS. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)[Internet]. 2010;68(9):534-540. Available from: https://sid.ir/paper/39565/en

IEEE: Copy

SAMILEH NOORBAKHSH, BEHROOZ JALILI, AHMAD REZA SHAMSHIRI, ELHAM SHIRAZI, AZARDOKHT TABATABAEI, REZA TAGHIPOUR, and AHMAD MODARES FATHI, “THE ROLE OF GROUP A BETA HEMOLYTIC STREPTOCOCCAL INFECTIONS IN PATIENTS WITH TIC AND TOURETT'S DISORDERS,” TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), vol. 68, no. 9, pp. 534–540, 2010, [Online]. Available: https://sid.ir/paper/39565/en

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