Characterization of B-Cells in tonsils of patients diagnosed with pediatric autoimmune neuropsychiatric disorder associated streptococcus

Int J Pediatr Otorhinolaryngol. 2016 Jan:80:49-52. doi: 10.1016/j.ijporl.2015.11.020. Epub 2015 Nov 24.


Objective: To determine if Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) patients demonstrate a significantly different number of B-Cells or markers of activity when compared to recurrent Group A Streptococcus or Obstructive Sleep Apnea patients.

Study design: Prospective Cohort Study.

Study setting: Academic University Hospital.

Methods: Tonsil tissue was collected from twenty-two patients in the operating room and organized into three groups. Ten clinically diagnosed PANDAS, six Group A Streptococcus and six Obstructive Sleep Apnea patients were included in this study. Each tissue sample was extracted with MSD Tris Lysis Buffer and protein lysates were analyzed for CD 19, B-Cell Activating Factor and B-Cell Activating Receptor by western blot methods.

Results: Based on ANOVA analysis, there was no significant difference in the expression of B-Cell Activating Factor, B-Cell Activating Receptor or CD 19 when comparing the three study groups by western blot analysis methods.

Conclusions: In this prospective cohort study, it appears that PANDAS patients do not demonstrate increased number of B-Cells, expression of B-Cell Activating Factor or B-Cell Activating Receptor when compared to Group A Streptococcus or Obstructive Sleep Apnea cohorts. As a result, further evaluation of the cell-mediated immune system is warranted to provide further insight into the pathophysiology of PANDAS. In addition, we must investigate if PANDAS patients only demonstrate increased B-Cell number or activity when undergoing an acute Tic/OCD exacerbation.

Keywords: Head and neck surgery; Otolaryngology; PANDAS; Pediatrics; Tonsillectomy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, CD19 / analysis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / microbiology
  • Autoimmune Diseases / psychology
  • B-Cell Activating Factor / analysis
  • B-Cell Activation Factor Receptor / analysis
  • B-Lymphocytes / chemistry*
  • B-Lymphocytes / pathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / etiology
  • Palatine Tonsil / chemistry*
  • Palatine Tonsil / pathology
  • Prospective Studies
  • Sleep Apnea, Obstructive / immunology
  • Streptococcal Infections / immunology*
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / psychology
  • Streptococcus pyogenes*


  • Antigens, CD19
  • B-Cell Activating Factor
  • B-Cell Activation Factor Receptor

Supplementary concepts

  • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections