Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS.
Citation: American Journal of Otolaryngology. 42(4):102963, 2021 Jul-Aug.PMID: 33706120Institution: MedStar Washington Hospital CenterDepartment: Psychiatry ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adenoidectomy | *Autoimmune Diseases/su [Surgery] | *Caregivers/px [Psychology] | *Parents/px [Psychology] | *Personal Satisfaction | *Streptococcal Infections/su [Surgery] | *Tonsillectomy | Adolescent | Adult | Anti-Bacterial Agents/tu [Therapeutic Use] | Autoimmune Diseases/co [Complications] | Child | Child, Preschool | Combined Modality Therapy | Humans | Immunoglobulins, Intravenous/tu [Therapeutic Use] | Middle Aged | Streptococcal Infections/co [Complications] | Time FactorsYear: 2021ISSN:- 0196-0709
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33706120 | Available | 33706120 |
CONCLUSION: Caregivers reported a decreasing frequency of symptoms over time regardless of treatment and had no difference in satisfaction. T&A was the most preferred treatment and the most impactful on symptoms for surgical patients. Given the challenges of immunologic therapies, T&A in combination with antibiotics should be considered as an early intervention for PANDAS. Copyright (c) 2021. Published by Elsevier Inc.
METHODS: A list was created for PANDAS subjects seen at the Georgetown Pediatric Otolaryngology clinic from 2015 to 2018. Questionnaires were distributed to caregivers able to be contacted; 62% responded (n = 60). Subjects were placed in groups based on treatments reported: tonsillectomy and adenoidectomy (T&A, n = 28), T&A and intravenous immunoglobulin (IVIG, n = 22), or nonsurgical treatment(s) (n = 10). Caregivers reported frequencies for each of 10 associated symptoms from time of treatment to 12 months and also expressed their satisfaction with treatment.
OBJECTIVE: To examine caregiver satisfaction with treatments for pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) and how symptom frequency changes over time.
RESULTS: Patients were treated with antibiotics (n = 60, 100%), T&A (83.3%), IVIG (40%), Rituximab (15%), steroids (20%), and/or plasma exchange (10%). Caregivers for 66% (n = 33) of surgical patients identified T&A as the most effective treatment, and 80% would choose the operation again. No difference in median caregiver satisfaction level was found among the groups (n = 0.196). There was no significant difference in frequency for any of the symptoms (all p > 0.05) except choreiform movement (p = 0.0296).
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