vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v18i5.2055vsp-2230Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWСовременные подходы к диагностике и лечению PANS/PANDASCurrent Approaches to PANS/PANDAS Diagnostics and Managementhttps://orcid.org/0000-0002-7383-3201КостикИ. А.KostikInna A.

Костик Инна Анатольевна - кандидат медицинских наук, невролог.

innakostik@yandex.ruhttps://orcid.org/0000-0002-1180-8086КостикМ. М.KostikMikhail M.Детский санаторий — Реабилитационный центр Детские ДюныРоссияChildren's Sanatorium-Rehabilitation Centre Detskye DunyRussian FederationСанкт-Петербургский государственный педиатрический медицинский университет; Национальный медицинский исследовательский центр им. В.А. АлмазоваРоссияSt. Petersburg State Pediatric Medical University; Almazov National Medical Research CenterRussian Federation201905012020185324338Copyright © Костик И.А., Костик М.М., 20202020Костик И.А., Костик М.М.Kostik I.A., Kostik M.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2230

PANS — педиатрический острый нейропсихический синдром, который характеризуется внезапным началом обсессивно-компульсивного синдрома, сопровождается тревогой, эмоциональной лабильностью и другими симптомами. PANDAS, или педиатрические аутоиммунные нейропсихические расстройства, ассоциированные со стрептококковой инфекцией, являются подтипом PANS. В статье представлены современные данные об этиологии, патогенезе, диагностике и лечении PANS/PANDAS. Проанализированы варианты выбора противовоспалительной и иммунотропной терапии, включающей применение нестероидных противовоспалительных препаратов, глюкокортикостероидов, внутривенного иммуноглобулина, плазмафереза, ритуксимаба, мофетила микофенолата.

PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is characterized by the sudden onset of obsessive-compulsive syndrome and accompanied by anxiety, emotional lability and other symptoms. PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections, is a subtype of PANS. Modern data on PANS/PANDAS etiology, pathogenesis, diagnostics and management is presented in this article. Therapeutic decisions on using anti-inflammatory and immunotropic therapy including non-steroidal anti-inflammatory drugs, glucocorticoids, intravenous immunoglobulin, plasmapheresis, rituximab and mycophenolate mofetil are analysed.

детиPANDASPANSCANSPITANDобсессивно-компульсивный синдромтикигиперкинезыстрептококкэтиологиядиагностикалечениеchildrenPANDASPANSCANSPITANDobsessive-compulsive syndrometichyperkinesisstreptococcusetiologydiagnosticsmanagementНе указанNot specifiedReferencesSwedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998; 155(2):264-271. doi: 10.1176/ajp.155.2.264.Swedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998; 155(2):264-271. doi: 10.1176/ajp.155.2.264.Allen AJ, Leonard HL, Swedo SE. Case study: a new infection-triggered, autoimmune subtype of pediatric OCD and Tourette's syndrome. J Am Acad Child Adolesc Psychiatry. 1995;34(3):307-311. doi: 10.1097/00004583-199503000-00015.Allen AJ, Leonard HL, Swedo SE. 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The authors declare that there are no conflicts of interest present.