AAP Update Needed: Abrupt and dramatic onset of OCD symptoms warrant strep test

AAP must update the Red Book® to include testing for strep when a child has an abrupt and dramatic onset of Obsessive Compulsive Disorder

MOORESVILLE, NC, USA, May 24, 2024 /EINPresswire.com/ -- The PANDAS Physicians Network is calling on the American Academy of Pediatrics (AAP) to update the recently published guidelines for Group A Streptococcal (GAS) testing in the Red Book^® to include testing when a child presents with an abrupt and dramatic onset of Obsessive Compulsive Disorder (OCD). The AAP needs to inform pediatricians of the importance of testing and treating these children to prevent the development of strep related complications such as rheumatic fever, Sydenham chorea, and neuroinflammatory brain disorders.

CRITICAL POINTS

1. The AAP’s omission of strep testing for children experiencing an alarming onset of obsessive-compulsive behaviors and/or eating restrictions has the potential for a misdiagnosis leading to significant harm.

Pediatricians should perform strep tests on children presenting with an abrupt and dramatic onset of obsessive-compulsive behavior and/or eating restrictions even if they are lacking pharyngitis and other classic signs of strep throat. It is a medical fact that asymptomatic and subclinical infections can produce dangerous sequelae including Sydenham chorea and acute rheumatic fever. “An association between Group A Strep infection and sudden onset of obsessive-compulsive behaviors, eating restrictions, and other neuropsychiatric symptoms has long been noted among patients with Sydenham chorea,” states Susan Swedo, MD, FAAP, Chief Science Officer, PANDAS Physicians Network.

Completing a simple, inexpensive strep test can lead to faster first line treatment in the pediatrician’s office, reduce long-term psychiatric suffering in impacted children, and prevent additional strep related complications. In contrast, forgoing a strep test in these children can contribute to significant delays in critical treatment, increase the likelihood of a child needing costly and more invasive medical interventions, and put an additional burden on other understaffed medical specialties.

2. A 5 year review of PANDAS is enough time to confirm the need to perform a strep test on children experiencing an abrupt and dramatic onset of obsessive-compulsive behaviors.

According to the current Red Book^®, “The American Academy of Pediatrics is reviewing PANDAS; it will not be covered in this (strep) chapter.” The AAP literature review of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) began in 2019 and has been under embargo for five years. Enough time has passed. The evidence from nearly 300 papers, case studies, and clinical trials demonstrates a strong association between abrupt onset OCD and strep infections, which can be effectively treated. By the time the next Red Book^® is published in 2027, an entire generation of children will be collateral damage due to the lack of urgency by the AAP to provide pediatricians accurate information on diagnosing and treating strep triggered neuroinflammatory brain disorders.

AAP CALL TO ACTION

The PANDAS Physicians Network calls on the AAP to update the Red Book^® immediately to inform pediatricians to test for strep when a child presents with an abrupt and dramatic onset of compulsions and obsessions, which may include irrational worries or fears, restrictive eating, or having an urge to complete repetitious actions, even if they are lacking pharyngitis and other classic signs of strep throat. Treating a strep infection can save lives and reduce suffering.

PANDAS PHYSICIANS NETWORK - A RESOURCE FOR PEDIATRICIANS

PANDAS Physicians Network (PPN) is a non-profit organization that provides PANS/PANDAS resources to clinicians while supporting research. Our vision is that these disorders will become easily diagnosed and treated with accessible therapies that dramatically reduce suffering and lead to a cure.

If a patient presents with an abrupt and dramatic onset of neuropsychiatric symptoms, testing for strep and other infections should be part of the evaluation process. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and the broader disorder of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) are immune-mediated brain disorders which can be triggered by infections like strep. Key symptoms include abrupt and dramatic onset of Obsessive Compulsive Disorder (OCD), Avoidant Restrictive Food Intake Disorder (ARFID), motor and sensory abnormalities, anxiety, irritability, and depression. Moderate to severe cases of PANS and PANDAS may be unable to attend school, experience psychiatric hospitalization, afflict self-harm, and in a constant state of psychological distress.

PANDAS Physicians Network has resources such as the diagnostic and treatment flowcharts to help evaluate patients and determine the best course of treatment. https://www.pandasppn.org

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