Background:
- Some children experience a sudden onset of symptoms similar to those found in
obsessive-compulsive disorder that may be caused by the body s reaction to an infection with
streptococcal bacteria, most commonly seen as strep throat or scarlet fever. When the body s
immune system reacts against brain cells following a streptococcal infection, the condition
is known as PANDAS (pediatric autoimmune neuropsychiatric disorders associated with
streptococcal infections). The immune system response can be inactivated by treatment with a
drug known as intravenous immunoglobulin (IVIG). Because there is insufficient research on
IVIG s effects on the immune system of children with PANDAS, including whether IVIG is
helpful in treating obsessive-compulsive symptoms related to PANDAS, researchers are
interested in examining whether IVIG is an appropriate treatment for PANDAS and its
associated symptoms.
Objectives:
- To test the safety and effectiveness of intravenous immunoglobulin for the treatment of
obsessive-compulsive disorder in children with PANDAS (pediatric autoimmune neuropsychiatric
disorder associated with streptococcal infection).
Eligibility:
- Children between 4 and 12 years of age who have obsessive-compulsive disorder (with or
without a tic disorder) with sudden onset of symptoms following Group A streptococcal
bacterial infections.
Design:
- Participants will be screened by telephone to obtain medical history and other
information, followed by in-person screening at the National Institutes of Health
Clinical Center.
- Participants will be admitted to the hospital to receive 2 days of infusions of either
IVIG or a placebo. Frequent blood samples, imaging studies, and other tests will be
performed during this visit.
- Six weeks after the inpatient stay, participants will return for further blood samples
and other tests. Participants who did not receive the study drug, or who received the
drug but did not respond to the initial IVIG infusion, will have the option to receive
IVIG at this time.
- Followup visits will take place 3 months and 6 months after the first evaluation,
followed by yearly follow-ups for 5 additional years.