What is PANDAS?
PANDAS, a fairly new disorder, has been gaining media attention because of the lack of research surrounding the factors and the unknown prevalence of the disorder itself. PANDAS, commonly known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a disorder that stems from untreated strep and results in the debilitating onset of obsessive compulsive disorder like symptoms, tics, anxiety, and changes in motors skills (changes in handwriting, speech, balance); these symptoms can happen overnight and have alarmed doctors and loved ones alike. Interestingly, PANDAS is often associated with the DSM-IV category, “Obsessive-Compulsive and Related Disorders” because of its OCD symptoms. Now, how does an untreated strep infection lead to these life-changing effects?
When strep goes untreated, it may trigger an immune response that results in inflammation on the brain—this inflammation is the direct cause of the onset symptoms. The symptoms will usually occur 4-6 months after the initial strep reaction. Streptococcal infections are often treated with antibiotics; however, the antibiotics may fail to eradicate the bacteria and build up will start to occur. The strep bacteria will partake in a process called molecular mimicry, in which the bacteria will place molecules familiar to the body (molecules found in tissue, on the heart, etc.) on its cell wall in order to remain undetected by the immune system. Once the immune system detects this foreign creation, antibodies will attack the mimicked molecules and the actual bacteria; this may be a cataract for the creation of antibodies that will start to target the brain, leading to the neuropsychiatric symptoms discussed above.
Other onset symptoms of PANDAS may include trouble sleeping, hyperactivity, inattention, separation anxiety (difficulty separating from parents), and mood changes. Children with PANDAS often experience the symptoms in episodes; there may be full remission of the OCD like symptoms during therapy and children often recall having good and bad days in regards to the symptoms. Treatment for this disorder typically involves antibiotics, as fighting the bacteria will alleviate the symptoms in due time. Immunoglobulin therapy has also been considered as a remedy for severely ill patients, as this plasma exchange is often used for immune disorders and may have side effects such as risk of infections, headaches, vomiting, and dizziness.
As more research is conducted on the subject, we can only hope that the prevalence will soon be known in order to familiarize the public and doctors with this ambitious disorder.
Writer: Gabriella Ademi
Editor: Audrey Kim
Sources:
https://www.nimh.nih.gov/health/publications/pandas/index.shtml
http://www.pandasnetwork.org/understanding-pandaspans/what-is-pandas/
https://emedicine.medscape.com/article/210367-overview
