Obsessive-compulsive disorder and acquired toxoplasmosis in two children

Abstract

Two children presenting symptoms of obsessive-compulsive disorder (OCD) and with acquired toxoplasmosis are described and the possibility of a previously rarely reported association between OCD and acquired toxoplasmosis is discussed. Case 1 is a 14-year-old boy with Tourette syndrome (TS), attention deficit hyperactivity disorder (ADHD) in partial remission and a three-year history of OCD referred to our department due to an acute deterioration of obsessive-compulsive (OC) symptoms. Case 2 is an 11-year-old boy referred to our department because of a two-year history of OCD. The OC symptoms were observed immediately following an infection. In both cases laboratory tests confirmed the diagnosis of acquired toxoplasmosis. The pharmacological therapy of T.gondi infection without any psychopharmacological treatment caused remission or significant improvement regarding OC symptoms.

The Neurotropic Parasite Toxoplasma Gondii Increases Dopamine Metabolism

“…Thus, it is crucial to determine if other pathogens associated with neurological disorders also have the ability to directly alter dopamine levels. It is also critical to determine the possible contributions of T. gondii infection to other dopamine-related diseases [33], [34].…”

Toxoplasma gondii infection and behaviour – location, location, location?

“…Increased incidence of seropositivity for T. gondii has been reported in cases of obsessive compulsive disorder (OCD) (OR=3.9, P<0.001) with 2.4 times higher seroprevalence in patients than in healthy volunteers (Miman et al, 2010b). OCD symptoms in individuals infected with T. gondii have been reduced by treatment of the T. gondii infection alone (Brynska et al, 2001;Smadja et al, 1995). There are contradictory reports on the association of T. gondii with Parkinson's disease as two preliminary studies showed opposing results; Miman and colleagues found that Parkinson's disease patients were significantly more likely to be seropositive for T. gondii (P<0.01) (Miman et al, 2010a) whilst Celik and colleagues did not find a statistically significant difference (Celik et al, 2010).…”

“…Several factors may determine whether the infection could lead to a disorder, and indeed which disorder it may lead to, such as combination with other genetic or environmental risk factors, the strain of T. gondii parasite with which the individual is infected, the time of the individual's life at which the infection occurs, the severity of the initial acute infection, and the exact number and location of parasite cysts within the brain during the chronic phase of infection. Toxoplasma gondii may confer a risk for neurological disorders as a result of damage caused by the initial infection, by the host's immune response to the parasite, or by the continued presence of parasitic cysts in the CNS; although alleviation of symptoms by treatment of the T. gondii infection (Brynska et al, 2001;Murakami et al, 2000;Smadja et al, 1995) implies an ongoing process beyond the initial acute infection.…”

Altered immunoglobulin profiles in children with Tourette syndrome

“…A subgroup of patients with TS with a medical history of GABHS infection prior to the onset of TS symptoms was designated as PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections ((Swedo et al, 1998). In addition, other infections were implicated in TS by studies demonstrating that common cold preceded TS symptom exacerbations (Hoekstra et al, 2005) and that antibodies against mycoplasma pneumoniae are elevated in patients with TS (Muller et al, 2004), and by case reports suggesting relations of TS with Lyme disease (Riedel et al, 1998) or toxoplasmosis (Brynska et al, 2001). Establishing evidence for the role of post-infectious autoimmunity in the pathogenesis of TS has proven quite challenging and the concept remains controversial (reviewed in (Giovannoni, 2006; Martino et al, 2009).…”