Strep throat, a common illness among school-age children, is caused by the Streptococcus pyogenes bacteria. Typically, a prescribed antibiotic swiftly resolves the infection. However, in approximately one out of every 200 children, strep throat triggers an immune response that leads to inflammation in the brain. This inflammation can then manifest in a sudden onset of neurologic abnormalities. Known as pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS), this syndrome is characterized by the development of behaviors such as obsessive-compulsive disorder (OCD) and personality changes shortly after a strep infection.
Symptoms of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
When children are diagnosed with PANDAS, it means they have recently tested positive for a streptococcal infection, such as strep throat (also known as GAS pharyngitis), scarlet fever, or peri-anal strep, which is an infection of the skin around the anus. Within a short period of time, usually two to three days but sometimes even overnight, the child begins to exhibit various symptoms. These symptoms include emotional instability, irritability, episodes of rage, sensory or motor abnormalities, sleep disturbances, issues with urinary control, refusal to eat, depression, and developmental regression.
In addition to these symptoms, children with PANDAS may also experience unwanted impulses, thoughts, and images known as obsessions, which can lead to anxiety. Furthermore, academic abilities may decline, including a deterioration in handwriting skills. It is important to note that if the child had already been experiencing symptoms of OCD or tics prior to the strep infection, these symptoms tend to worsen after the development of PANDAS.
Causes of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
Understanding the causes of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) has been a complex task for researchers. Unfortunately, the studies conducted on this syndrome have been limited to small populations, resulting in low-quality research and conflicting outcomes. As a result, the medical community is yet to determine the exact pathophysiology of PANDAS, leaving the causes to be based on theories.
While some individuals question the existence of PANDAS, one of the most widely accepted causal theories suggests that a strep infection can act as a triggering factor for an autoimmune response, ultimately leading to the development of PANDAS. Additionally, some researchers propose the presence of a genetic predisposition for the syndrome, wherein the strep infection serves as a catalyst.