PANDAS Diagnosis Siscussion

I need a paper written on these 3 discussions. Please tell what you like, dislike, agree or disagree with on each of them. Please keep them separate. Write a paragraph or two for each. Make sure you understand the biology involved. Discussion 1: Children who have PANDAS usually have a dramatic, "overnight" onset of symptoms, including tics, obsessions, and/or compulsions. This abrupt onset is generally preceded by a strep throat infection. The mechanism behind this phenomenon is still unknown but researchers at the NIMH are pursuing a theory that the mechanism is similar to that of Rheumatic Fever, an autoimmune disorder triggered by strep throat infections. In patients with Rheumatic Fever, the persons' antibodies mistakenly recognize and "attack" the heart valves, joints, and/or certain parts of the brain - a phenomenon known as "molecular mimicry.” Because the antibodies set off an immune reaction that damages those tissues, children with Rheumatic Fever can get heart disease, arthritis, and/or experience abnormal movements. Interestingly, penicillin and other antibiotics that kill streptococcus and other types of bacteria aren't effective in treating PANDAS, as the antibodies produced by the body in response to the strep infection are the cause of the problem, not the bacteria themselves. Our bodies are infection fighting, germ destroying machines, and knowing just how complex the inner workings of our immune systems have to be in order to ward off attacks from the many microorganisms that thrive all around us is nothing short of miraculous. That's what makes autoimmune diseases so sad in my opinion – the idea that our bodies, which for healthy individuals do such a good job protecting us - can turn against us and many times there is little we can do to stop it. When thinking about autoimmune deficiencies, the first disease that came to my mind was AIDS, but AIDS which stands for Acquired Immune Deficiency is much different from Autoimmune Disease (shortened to AID). In AID the autoimmune system needs to be suppressed to stop it from attacking the body, while for AIDS the immune system is too weak (due to HIV) to defend itself against infections, so you could die from what started as a common cold. AID is generally not contagious while AIDS is. There are many commonly known autoimmune diseases. Examples include hepatitis, cancer, celiac disease, psoriasis, rheumatoid arthritis, Crohns disease, even certain types of alopecia. For as disease to be classified as an autoimmune disease it needs to meet Witebsky's postulates: - Direct evidence from transfer of pathogenic antibody or pathogenic T cells - Indirect evidence based on reproduction of the autoimmune disease in experimental animals - Circumstantial evidence from clinical clues http://www(dot)wisegeek(dot)com/how-does-the-human-body-fight-infections.htm http://www(dot)nimh(dot)nih(dot)gov/health/publications/pandas/index.shtml http://en(dot)wikipedia(dot)org/wiki/Autoimmune_disease http://en(dot)wikipedia(dot)org/wiki/PANDAS http://www(dot)pemphigus(dot)org/explaining-your-autoimmune-disease-aid-is-not-aids/ Discussion 2: After reading this description of PANDAS, my first reaction was doubt. However, research has shown that there may be some truth in the statement that neurological disorders are caused by bacterial infections. For example, research has shown that individuals with tic disorders such as Tourette's syndrome (TS) have an elevated blood titer of anti-neural antibodies. Furthermore, this population of antibodies was determined to be the result of a group A beta hemolytic streptococcal (GABHS) infection (a). In addition, attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD) each have significant rates of co-morbidity with TS, 60-80% and 11-80%, respectively (b). A history of GABHS infection may have led to the prevalence of anti-neural antibodies, indicating that PANDAS may have more validity that first thought. Two well-known syndromes that can result from a microbial infection include Guillain-Barre syndrome and rheumatic fever (c). Furthermore, it is important to note that one must be mindful that every individual has a degree of genetic susceptibility to develop these specific syndromes following a microbial infection. This could prove to be an important, while also controversial, topic in the future as personalized medicine tactics become more prevalent. Ultimately, the knowledge that an autoimmune disorder may be caused by a previous bacterial infection will only be useful if an appropriate treatment plan is available and utilized. For example, if an individual is known to have a high genetic susceptibility to one of these disorders following a bacterial infection, treatments to clear or chelate anti-neural antibodies from the blood may be useful to prevent further progression of the disorder. Regardless if it applies to PANDAS-type disorders, researchers and patients must be mindful of the fact that prior infections can have a widespread impact on human physiology and determine immune response in the future. References (a) http://www(dot)sciencedirect(dot)com/science/article/pii/S0006322301010964 (b) http://www(dot)sciencedirect(dot)com/science/article/pii/S221053361300097X (c) http://www(dot)jci(dot)org/articles/view/14235 Discussion 3: PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. I was simply awed when I read about this. I knew that Strep throat caused rheumatic fever. Wow, this is so much worse. Children develop a very sudden onset of dramatic symptoms. The obsessive thoughts, compulsive behaviors and motor or vocal tics appeared "overnight" and "out of the blue" and usually reach full scale potential in 24-48 hours. The OCD and TIC symptoms were accompanied by separation anxiety, anxiety attacks, irritability, and extreme mood swings. It is not uncommon to see temper tantrums. NIMH researchers have discovered the aftermath of bacterial infections brought about the new OCD,TICS, and other symptoms. Rheumatic fever is a collection of illnesses that occurs from untreated or partially treated Streptococcal infections, primarily(strep throat and scarlet fever). Rheumatic fever includes (carditis), joint disease (arthritis), skin abnormalities and neurologic symptoms. Children suspected of having PANDAS are checked for strep throat by swabbing the throat and by a strep culture. They are usually treated with antibiotics if the result is positive. They are also treated with cognitive behavioral therapy and SSRI medications. Bacteria and viruses can cause autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, lupus inflammation, bowel diseases and scleroderma. Infections can cause the illness by serving as a factor in the disease process. Chronic bacterial infections have been linked to Rheumatoid disorders. Recovery is a slow, painful process for people that develop autoimmune diseases. It usually takes over a year or more to recover WORKS CITED www(dot)immed(dot)org/illness/autoimmune_illness_research.html www(dot)intramural(dot)nimh(dot)nih(dot)gov/pdn/web.htm http://threadcontent(dot)next(dot)ecollege(dot)com/(NEXT(7e854bcdlb)/Main/CourseMode/Thread/