Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever

Am J Psychiatry. 1997 Jan;154(1):110-2. doi: 10.1176/ajp.154.1.110.


Objective: The authors' goal was to determine whether a trait marker of rheumatic fever susceptibility (labeled D8/17) could identify children with pediatric autoimmune neuropsychiatric disorders (obsessive-compulsive disorder and tic disorders) associated with streptococcal infections (PANDAS).

Method: Blood samples obtained from 27 children with PANDAS, nine children with Sydenham's chorea, and 24 healthy children were evaluated for D8/17 reactivity. Individuals were defined as D8/17 positive if they had 12% or more D8/17+ cells.

Results: The frequency of D8/17-positive individuals was significantly higher in both patient groups than it was among the healthy volunteers: 85% of the children with PANDAS and 89% of the children with Sydenham's chorea, compared with 17% of the healthy children, were D8/17 positive. Further, the mean number of D8/17+ cells was similar in the two patient groups and was significantly higher in these groups than in the group of healthy children.

Conclusions: These results suggest that there may be a subgroup of D8/17-positive children who present with clinical symptoms of obsessive-compulsive disorder and Tourette's syndrome, rather than Sydenham's chorea, but who have similar poststreptococcal autoimmunity.

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal / immunology
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / immunology
  • Biomarkers*
  • Child
  • Child, Preschool
  • Chorea / immunology*
  • Female
  • Genetic Predisposition to Disease
  • HLA-DR Antigens / immunology*
  • Humans
  • Lymphocyte Subsets / immunology*
  • Male
  • Obsessive-Compulsive Disorder / diagnosis*
  • Rheumatic Fever / genetics
  • Rheumatic Fever / immunology*
  • Streptococcal Infections / immunology*


  • Antibodies, Monoclonal
  • Biomarkers
  • HLA-DR Antigens