PANDAS - Revision history

Prab: CSV import

2025-04-09T05:36:10Z

CSV import

← Older revision		Revision as of 05:36, 9 April 2025
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			{{SI}}
			{{Infobox medical condition
			\| name = Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
			\| image = [[File:Streptococcus_pyogenes_01.jpg\|left\|thumb\|Streptococcus pyogenes]]
			\| caption = ''[[Streptococcus pyogenes]]'', the bacterium associated with PANDAS
			\| field = [[Psychiatry]], [[Neurology]], [[Pediatrics]]
			\| symptoms = [[Obsessive-compulsive disorder\|Obsessive-compulsive symptoms]], [[tics]], [[anxiety]], [[emotional lability]], [[behavioral regression]]
			\| complications = [[Chronic tic disorder]], [[Obsessive-compulsive disorder]]
			\| onset = [[Childhood]]
			\| duration = Variable
			\| causes = [[Group A streptococcal infection]]
			\| risks = [[Genetic predisposition]], [[autoimmune response]]
			\| diagnosis = Clinical evaluation, [[throat culture]], [[antistreptolysin O]] titer
			\| differential = [[Sydenham's chorea]], [[Tourette syndrome]], [[Obsessive-compulsive disorder]]
			\| treatment = [[Antibiotics]], [[cognitive behavioral therapy]], [[immunomodulatory therapy]]
			\| medication = [[Antibiotics]], [[Selective serotonin reuptake inhibitors]]
			\| prognosis = Variable; some children recover fully, others may have persistent symptoms
			\| frequency = Unknown, but considered rare
			\| deaths = None directly attributed
			}}
			[[File:Proposed_PANDAS.svg\|Proposed PANDAS\|thumb\|left]]
	Pediatric autoimmune neuropsychiatric disorders associated with [[Streptococcus]] infections		Pediatric autoimmune neuropsychiatric disorders associated with [[Streptococcus]] infections

	<youtube>		<youtube>
	title='''{{PAGENAME}}'''		title='''{{PAGENAME}}'''
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	height=600		height=600
	</youtube>		</youtube>

	==Other Names==		==Other Names==
	PANDAS; Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus; Pediatric autoimmune disorders associated with Streptococcus infections		PANDAS; Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus; Pediatric autoimmune disorders associated with Streptococcus infections

	==Pathophysiology==		==Pathophysiology==
	* Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections (PANDAS) is a neurological and psychiatric condition in which symptoms are brought on or worsened by a Streptococcal (strep) infection.		* Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections (PANDAS) is a neurological and psychiatric condition in which symptoms are brought on or worsened by a Streptococcal (strep) infection.
	* PANDAS is a subtype of pediatric acute-onset neuropsychiatric syndrome (PANS).		* PANDAS is a subtype of pediatric acute-onset neuropsychiatric syndrome (PANS).

	==Signs and symptoms==		==Signs and symptoms==
	* Signs and symptoms of PANDAS align with current guidelines for diagnosing PANDAS, and include:		* Signs and symptoms of PANDAS align with current guidelines for diagnosing PANDAS, and include:
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	* Symptoms appear between 3 years of age and puberty (although later onset of symptoms is possible).		* Symptoms appear between 3 years of age and puberty (although later onset of symptoms is possible).
	* Symptoms appear abruptly and dramatically (typically within one to two days) and may repeatedly improve and then suddenly worsen (a relapsing and remitting course).		* Symptoms appear abruptly and dramatically (typically within one to two days) and may repeatedly improve and then suddenly worsen (a relapsing and remitting course).

	==Association with Streptococcus infection==		==Association with Streptococcus infection==
	* There is an association between symptom onset or worsening and a group A Streptococcal (GAS) infection. Symptom flares must be associated with a positive throat culture and/or blood tests that show elevated antibodies against a substance produced by GAS (called anti-GAS titers).		* There is an association between symptom onset or worsening and a group A Streptococcal (GAS) infection. Symptom flares must be associated with a positive throat culture and/or blood tests that show elevated antibodies against a substance produced by GAS (called anti-GAS titers).
	* Children with PANDAS often do not complain of a sore throat despite having an infection.		* Children with PANDAS often do not complain of a sore throat despite having an infection.
	* After the initial infection, subsequent flares can be associated with other infectious or environmental triggers.		* After the initial infection, subsequent flares can be associated with other infectious or environmental triggers.
	* There are other neurologic abnormalities.		* There are other neurologic abnormalities.
	* When symptoms of PANDAS are present, a neurological exam will be abnormal.		* When symptoms of PANDAS are present, a neurological exam will be abnormal.
	* Abnormalities may include any of the additional neuropsychiatric symptoms that occur in people with PANS.		* Abnormalities may include any of the additional neuropsychiatric symptoms that occur in people with PANS.

	==Cause==		==Cause==
	The underlying cause of PANDAS is unclear, but studies suggest that a strep infection causes an abnormal immune response resulting in neuropsychiatric symptoms.		The underlying cause of PANDAS is unclear, but studies suggest that a strep infection causes an abnormal immune response resulting in neuropsychiatric symptoms.

	==Onset and progression==		==Onset and progression==
	* PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.		* PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.
	* It describes the abrupt onset or worsening of symptoms in children who have obsessive-compulsive disorder or a tic disorder (i.e. Tourette syndrome), following a group A streptococcal infection (strep infection). Following a strep infection, children affected by PANDAS typically experience a sudden onset of motor or vocal tics; obsessions; and/or compulsions.		* It describes the abrupt onset or worsening of symptoms in children who have obsessive-compulsive disorder or a tic disorder (i.e. Tourette syndrome), following a group A streptococcal infection (strep infection). Following a strep infection, children affected by PANDAS typically experience a sudden onset of motor or vocal tics; obsessions; and/or compulsions.
	* These severe symptoms typically last from several weeks to several months. After a gradual improvement, children may not experience any additional problems until they contract another strep infection.		* These severe symptoms typically last from several weeks to several months. After a gradual improvement, children may not experience any additional problems until they contract another strep infection.

	Children may also experience the following signs and symptoms during a PANDAS episode:		Children may also experience the following signs and symptoms during a PANDAS episode:
	* Moodiness and irritability		* Moodiness and irritability
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	* Concentration difficulties and loss of academic abilities		* Concentration difficulties and loss of academic abilities
	* Developmental regression (i.e. temper tantrums, "baby talk")		* Developmental regression (i.e. temper tantrums, "baby talk")

	==Diagnosis==		==Diagnosis==
	A diagnosis of PANDAS is based on the presence of the following:		A diagnosis of PANDAS is based on the presence of the following:
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	Association with group A streptococcal infection (in some cases, the affected person has no obvious symptoms of a strep infection; however, a throat culture and/or blood tests may show evidence of a current or recent infection)		Association with group A streptococcal infection (in some cases, the affected person has no obvious symptoms of a strep infection; however, a throat culture and/or blood tests may show evidence of a current or recent infection)
	Association with other neuropsychiatric symptoms (i.e. separation anxiety, ADHD, developmental regression, etc)		Association with other neuropsychiatric symptoms (i.e. separation anxiety, ADHD, developmental regression, etc)

	==Treatment==		==Treatment==
	* The treatment of PANDAS is symptomatic.		* The treatment of PANDAS is symptomatic.
	* Children who are diagnosed with a group A streptococcal infection are typically treated with antibiotics whether or not they develop symptoms of PANDAS.		* Children who are diagnosed with a group A streptococcal infection are typically treated with antibiotics whether or not they develop symptoms of PANDAS.
	* Obsessive-compulsive disorders are usually managed with medications (i.e. SSRI medications such as [[fluoxetine]], [[fluvoxamine]], [[sertralin]]e, or [[paroxetine]]) and cognitive behavioral therapy. Tic disorders are often treated with a variety of medications, as well.		* Obsessive-compulsive disorders are usually managed with medications (i.e. SSRI medications such as [[fluoxetine]], [[fluvoxamine]], [[sertralin]]e, or [[paroxetine]]) and cognitive behavioral therapy. Tic disorders are often treated with a variety of medications, as well.

	==IVIG and plasmapheresis==		==IVIG and plasmapheresis==
	* Some researchers suspect that therapies such as plasmapheresis and/or [[intravenous immunoglobulin]] (IVIG), which are often used to treat autoimmune disorders, may be a treatment option for children with PANDAS.		* Some researchers suspect that therapies such as plasmapheresis and/or [[intravenous immunoglobulin]] (IVIG), which are often used to treat autoimmune disorders, may be a treatment option for children with PANDAS.
	* [[Plasmapheresis]] is a procedure that removes antibodies from the blood.		* [[Plasmapheresis]] is a procedure that removes antibodies from the blood.
	* IVIG can sometimes be used to alter the function or production of abnormal antibodies.		* IVIG can sometimes be used to alter the function or production of abnormal antibodies.
	* These treatments are often reserved for severely affected children who do not respond to other therapies.		* These treatments are often reserved for severely affected children who do not respond to other therapies.

	==External links==		==External links==
	*[https://rarediseases.info.nih.gov/diseases/13087/pediatric-acute-onset-neuropsychiatric-syndrome]		*[https://rarediseases.info.nih.gov/diseases/13087/pediatric-acute-onset-neuropsychiatric-syndrome]
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	[[Category:Neurological disorders]]		[[Category:Neurological disorders]]
	[[Category:Syndromes]]		[[Category:Syndromes]]
	~~<gallery>~~
	~~File:Streptococcus_pyogenes_01.jpg~~
	~~File:Proposed_PANDAS.svg~~
	~~</gallery>~~

Prab: CSV import

2025-02-17T02:08:07Z

CSV import

← Older revision		Revision as of 02:08, 17 February 2025
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	[[Category:Neurological disorders]]		[[Category:Neurological disorders]]
	[[Category:Syndromes]]		[[Category:Syndromes]]
			<gallery>
			File:Streptococcus_pyogenes_01.jpg
			File:Proposed_PANDAS.svg
			</gallery>

Prab at 20:03, 28 May 2023

2023-05-28T20:03:42Z

New page

Pediatric autoimmune neuropsychiatric disorders associated with [[Streptococcus]] infections

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title='''{{PAGENAME}}'''
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width=750
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</youtube>

==Other Names==
PANDAS; Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus; Pediatric autoimmune disorders associated with Streptococcus infections

==Pathophysiology==
* Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus infections (PANDAS) is a neurological and psychiatric condition in which symptoms are brought on or worsened by a Streptococcal (strep) infection.
* PANDAS is a subtype of pediatric acute-onset neuropsychiatric syndrome (PANS).

==Signs and symptoms==
* Signs and symptoms of PANDAS align with current guidelines for diagnosing PANDAS, and include:
* The presence of obsessive-compulsive disorder (OCD) and/or tics (uncontrolled, sudden, repetitive movements or sounds), which are severe enough to interfere the ability to function.
* Symptoms appear between 3 years of age and puberty (although later onset of symptoms is possible).
* Symptoms appear abruptly and dramatically (typically within one to two days) and may repeatedly improve and then suddenly worsen (a relapsing and remitting course).

==Association with Streptococcus infection==
* There is an association between symptom onset or worsening and a group A Streptococcal (GAS) infection. Symptom flares must be associated with a positive throat culture and/or blood tests that show elevated antibodies against a substance produced by GAS (called anti-GAS titers).
* Children with PANDAS often do not complain of a sore throat despite having an infection.
* After the initial infection, subsequent flares can be associated with other infectious or environmental triggers.
* There are other neurologic abnormalities.
* When symptoms of PANDAS are present, a neurological exam will be abnormal.
* Abnormalities may include any of the additional neuropsychiatric symptoms that occur in people with PANS.

==Cause==
The underlying cause of PANDAS is unclear, but studies suggest that a strep infection causes an abnormal immune response resulting in neuropsychiatric symptoms.

==Onset and progression==
* PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus.
* It describes the abrupt onset or worsening of symptoms in children who have obsessive-compulsive disorder or a tic disorder (i.e. Tourette syndrome), following a group A streptococcal infection (strep infection). Following a strep infection, children affected by PANDAS typically experience a sudden onset of motor or vocal tics; obsessions; and/or compulsions.
* These severe symptoms typically last from several weeks to several months. After a gradual improvement, children may not experience any additional problems until they contract another strep infection.

Children may also experience the following signs and symptoms during a PANDAS episode:
* Moodiness and irritability
* Separation anxiety
* ADHD symptoms
* Sleep disturbances
* Night-time bed wetting and/or day-time urinary frequency
* Fine motor changes (handwriting)
* Joint pain
* Concentration difficulties and loss of academic abilities
* Developmental regression (i.e. temper tantrums, "baby talk")

==Diagnosis==
A diagnosis of PANDAS is based on the presence of the following:
Obsessive-compulsive disorder or a tic disorder (i.e. Tourette syndrome)
Symptoms develop before age 12
Abrupt onset of symptoms and "episodic" course (relapses are separated by periods of time in which children have less severe or no symptoms)
Association with group A streptococcal infection (in some cases, the affected person has no obvious symptoms of a strep infection; however, a throat culture and/or blood tests may show evidence of a current or recent infection)
Association with other neuropsychiatric symptoms (i.e. separation anxiety, ADHD, developmental regression, etc)

==Treatment==
* The treatment of PANDAS is symptomatic.
* Children who are diagnosed with a group A streptococcal infection are typically treated with antibiotics whether or not they develop symptoms of PANDAS.
* Obsessive-compulsive disorders are usually managed with medications (i.e. SSRI medications such as [[fluoxetine]], [[fluvoxamine]], [[sertralin]]e, or [[paroxetine]]) and cognitive behavioral therapy. Tic disorders are often treated with a variety of medications, as well.

==IVIG and plasmapheresis==
* Some researchers suspect that therapies such as plasmapheresis and/or [[intravenous immunoglobulin]] (IVIG), which are often used to treat autoimmune disorders, may be a treatment option for children with PANDAS.
* [[Plasmapheresis]] is a procedure that removes antibodies from the blood.
* IVIG can sometimes be used to alter the function or production of abnormal antibodies.
* These treatments are often reserved for severely affected children who do not respond to other therapies.

==External links==
*[https://rarediseases.info.nih.gov/diseases/13087/pediatric-acute-onset-neuropsychiatric-syndrome]
*[http://www.nimh.nih.gov/about/director/2012/from-paresis-to-pandas-and-pans.shtml NIMH Director's Blog]
{{stub}}
{{rarediseases}}
[[Category:Childhood psychiatric disorders]]
[[Category:Neurological disorders]]
[[Category:Syndromes]]