My Child's Health   >>   PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)

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PANDAS is not well understood in the Medical Community. Often times it is missed. If it is considered, the recommended treatment is ineffective, driving the problem deeper into the system.

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PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)


Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) facts

  • PANDAS is an acronym for "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections."
  • It is a fairly recently described disorder (1990s).
  • An autoimmune response to a streptococcal B infection is the leading theory as to the cause of PANDAS.
  • It is diagnosed if there is a history of abrupt development of a number of neuropsychiatric symptoms associated with a group B streptococcal (the type of bacteria causing strep throat) infection.
  • Medication and cognitive behavioral therapy (CBT) are the primary treatments for PANDAS.


What is PANDAS?


PANDAS is an acronym that refers to "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections." It is diagnosed clinically after a patient develops a number of behavioral and physical symptoms following a streptococcal infection (for example, strep throat, sinusitis, cellulitis, or scarlet fever).


Is PANDAS Common?


PANDAS is reported as a rare condition, because it is poorly understood and not properly educated about in Allopathic Medicine Schooling. It is currently believed that approximately one in 2,000 children are affected, though the diagnosis may be overlooked due to some of the common symptoms associated with the disease. In fact, there are some researchers who recommend categorizing PANDAS as a subset of other disorders, which includes similar neuropsychiatric symptoms called CANS (Childhood Acute Neuropsychiatric Symptoms) or PANS (Pediatric Acute-onset Neuropsychiatric Syndrome).


What is the History of PANDAS?


PANDAS was first described in the late 1990s after investigators identified a subgroup of children who developed a sudden onset of Obsessive-Compulsive Disorder (OCD) symptoms, vocal and motor tics, and other behavioral changes. They identified that there was a common association in these children, and that was identified as a recent or active infection with a beta-hemolytic Streptococcus (Strep B), the bacteria that causes strep throat. Researchers also identified a number of other infectious agents, known to cause significant auto-inflammatory reactions associated with neuropsychiatric symptoms, including influenza, varicella (associated with Chicken Pox), and even Borrelia burgdorferi (Lyme disease), but the diagnosis of PANDAS is limited to streptococcal infections.


What Are the Potential Complications of Strep Throat?


The possible complications of strep throat include

  • acute rheumatic fever
  • glomerulonephritis
  • otitis media (middle ear infection)
  • Toxic shock syndrome (a rare but severe complication which may result in the failure of multiple organs and may thus be fatal)
  • Peritonsillar abscess or retropharyngeal abscess (walled off infection containing GAS bacteria and pus which may encroach upon the structures in the back of the throat or invade and rupture into deeper structures which may ultimately be fatal), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep)


What Causes PANDAS?


Consensus opinion is that PANDAS is in part caused by an autoimmune response to a strep B infection. Streptococcus B is known to be associated with a number of immune-related disorders, including rheumatic fever, scarlet fever, and acute glomerulonephritis (a kidney disorder). The strep molecules are known to hide from the host Immune System by mimicking host cells. Ultimately, the immune system recognizes the foreign cells, and the antibodies produced attack the bacterium, and unfortunately, some of the host's own cells are attacked as well due to cross-reactivity. In some situations, these antibodies attack brain cells, causing OCD, tics, and the other symptoms frequently observed in PANDAS patients.


What are Risk Factors for PANDAS?


Multiple risk factors may play a role in the development of PANDAS, including

  • recurrent group B streptococcal infections,
  • family history of rheumatic fever, and
  • the mother's history of having an autoimmune disease.

PANDAS is also more common in boys and prepubertal children.

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