As a physician who has treated many cases of this enigmatic disease, I can tell you that it is not a easy diagnosis. Patients will have a myriad of signs and symptoms, many of them atypical on the surface, but there is a pattern to this disease that can be recognized after careful thought and investigation.
PANDAS is an acronym for “Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection.” This condition was first described by Dr. Susan Swedo at the National Institute of Mental Health in 1998. It has been described as presenting with an acute onset of Obsessive Compulsive Disorder (OCD) and/or motor tics in children with a recent streptococcal infection. The clinical existence of PANDAS was published in a 2002 study by Dr. Pichichero, showing evidence of an association between Strep A Pharyngitis and abrupt onset of OCD in 12 children. In all 12 children, treatment with antibiotics resulted in a rapid reduction in OCD symptoms. PANDAS is classified as one of the conditions with neuropsychiatric illness associated with an autoantibody. The first condition of in this spectrum was Sydenham’s chorea. Recently many cases of acute neuropsychiatric changes have been described with systemic lupus and other autoimmune diseases.
As with many autoimmune diseases, the diagnosis is not straightforward and treatment has to be tailored to the individual. As local physicians with expertise in treating PANDAS, we welcome inquiries and are able to evaluate and manage patients with this complex disease at our Dunkirk, Edgewater or Kent Island office. You may also want to visit the NIH website to learn more about PANDAs or www.southriverpediatrics.com.
Azam Baig, MD, South River Pediatrics