The acronym PANDAS stands for:
pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections.
That is a whole mouthful, you’ll agree.
We’re talking about a unique sub-set of psychiatric patients: there are children in whom an acute manifestation of OCD and/or tic disorders occurs. This is special, because with OCD the symptoms usually develop over time.
The disorders were initially thought to be caused by infection with Group-A beta-hemolytic Streptococcus (GABHS).
Susan Swedo and her group published an important research report on this in 1998.
Two decades later, there have been changes in the concept of PANDAS; actually, it is now named: PANS (pediatric acute-onset neuropsychiatric syndrome). It hasn’t been accepted as a distinct disorder (or group of disorders) yet – but that doesn’t mean there haven’t been additional findings.
- several agents other than Streptococcus may be involved in its inception
- there is a male predominance in the patient population: 65% of it is male
- 54% of those affected show a specific association with Streptococcus
- gender and pubertal status have a strong effect on symptom course and chronicity of the illness
- the rate of co-occurring medical illness is high – a general immune dysfunction is suggested by experts
- PANS has a considerable impact on the daily life of the children
- antibiotic treatment is advised to resolve the symptoms of infection early on
- it may be that the resident immune cells of the brain, the microglia, aren’t functioning well in PANS
Now, we are lucky: some fine articles on these matters are available at the open source of the National Institute for Mental Health, in Bethesda, Maryland, via the Pubmed site:
…and here’s a figure (sans comment) to whet your appetite, from the first article: