Pediatric autoimmune neuropsychiatry disorders associated with streptococcus: Comparison of diagnosis and treatment in the community and at a specialty clinic

Vilma Gabbay, Barbara J. Coffey, James S. Babb, Laura Meyer, Carly Wachtel, Seeba Anam, Beth Rabinovitz

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

OBJECTIVES. This study aimed to examine whether pediatric autoimmune neuropsychiatry disorders associated with streptococcus were appropriately diagnosed in the community and to determine subsequent rates of unwarranted use of antibiotic treatment for tics and obsessive-compulsive symptoms without the identification of an infection. METHODS.The design was a retrospective, cross-sectional, observational study of 176 children and adolescents who were evaluated in a specialty program for tics, Tourette's disorder, and related problems. Previously published diagnostic criteria were used to establish the diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus in our clinic. RESULTS. Subjects were significantly less likely to receive a diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus at the specialty clinic than in the community. In the community, subjects were significantly more likely to be treated with antibiotics or immunosuppressant medication if they received a diagnosis of pediatric autoimmune neuropsychiatric disorders associatedwith streptococcus. Of the 27 subjects with a community diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus who were treated with antibiotics, 22 (82%) were treated without laboratory evidence of an infection;2 were treated with immunomodulatory medications. CONCLUSIONS. Our results support our hypothesis that pediatric autoimmune neuropsy-chiatric disorders associated with streptococcus are frequently diagnosed in the community without the application of all working diagnostic criteria. This phenomnon has resulted in unwarranted use of antibiotic treatment for tics/obsessive-compulsive disorder without evidence of laboratory infection. Copyringt

Original languageEnglish (US)
Pages (from-to)273-278
Number of pages6
JournalPediatrics
Volume122
Issue number2
DOIs
StatePublished - Aug 2008
Externally publishedYes

Keywords

  • Antibiotic treatment
  • Group A β-hemolytic streptococcus
  • Obsessive-compulsive disorder
  • Pediatric autoimmune neuropsychiatric disorders associated with streptococcus
  • Tics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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