Editing Group A streptococcal infection (section)

===PANDAS===
[[Obsessive–compulsive disorder]] and [[tic disorder]]s are hypothesized to arise in a subset of children as a result of a post-[[streptococcus|streptococcal]] autoimmune process.<ref name= Dale2017/><ref name= Marazziti2018/><ref name= Zibordi2018/> Its potential effect was described in 1998 by the controversial hypothesis called [[PANDAS]] (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections), a condition thought to be triggered by GABHS infections.<ref name= Wilbur2019>{{cite journal |vauthors=Wilbur C, Bitnun A, Kronenberg S, Laxer RM, Levy DM, Logan WJ, Shouldice M, Yeh EA |title=PANDAS/PANS in childhood: Controversies and evidence |journal=Paediatr Child Health |volume=24 |issue=2 |pages=85–91 |date=May 2019 |pmid=30996598 |pmc=6462125 |doi=10.1093/pch/pxy145}}</ref><ref name=Sigra2018>{{cite journal |vauthors=Sigra S, Hesselmark E, Bejerot S |title=Treatment of PANDAS and PANS: a systematic review |journal=Neurosci Biobehav Rev |volume=86 |issue= |pages=51–65 |date=March 2018 |pmid=29309797 |doi=10.1016/j.neubiorev.2018.01.001 |s2cid=40827012 |doi-access=free }}</ref> The PANDAS hypothesis is unconfirmed and unsupported by data, and two new categories have been proposed: [[PANDAS|PANS]] (pediatric acute-onset neuropsychiatric syndrome) and CANS (childhood acute neuropsychiatric syndrome).<ref name= Marazziti2018/><ref name= Zibordi2018/> The CANS/PANS hypotheses include different possible mechanisms underlying acute-onset neuropsychiatric conditions, but do not exclude GABHS infections as a cause in a subset of individuals.<ref name= Marazziti2018/><ref name= Zibordi2018/> PANDAS, PANS and CANS are the focus of clinical and laboratory research but remain unproven.<ref name= Dale2017>{{cite journal |vauthors=Dale RC |title=Tics and Tourette: a clinical, pathophysiological and etiological review |journal=Curr Opin Pediatr |volume=29 |issue=6 |pages=665–673 |date=December 2017 |pmid=28915150 |doi=10.1097/MOP.0000000000000546 |s2cid=13654194 |type= Review}}</ref><ref name= Marazziti2018>{{cite journal |vauthors=Marazziti D, Mucci F, Fontenelle LF |title=Immune system and obsessive-compulsive disorder |journal=Psychoneuroendocrinology |volume=93 |pages=39–44 |date=July 2018 |pmid=29689421 |doi=10.1016/j.psyneuen.2018.04.013 |s2cid=13681480 |type= Review}}</ref><ref name= Zibordi2018>{{cite journal |vauthors=Zibordi F, Zorzi G, Carecchio M, Nardocci N |title=CANS: Childhood acute neuropsychiatric syndromes |journal=Eur J Paediatr Neurol |volume=22 |issue=2 |pages=316–320 |date=March 2018 |pmid=29398245 |doi=10.1016/j.ejpn.2018.01.011 |type= Review}}</ref>