PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: Roxanne Dryden-Edwards, MD
    Roxanne Dryden-Edwards, MD

    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Just a Sore Throat or Strep Slideshow
Children with strep throat

What Are the Potential Complications of Strep Throat?

The possible complications of strep throat include

  • acute rheumatic fever,
  • glomerulonephritis,
  • otitis media (middle ear infection),
  • Toxic shock syndrome (a rare but severe complication which may result in the failure of multiple organs and may thus be fatal),
  • Peritonsillar abscess or retropharyngeal abscess (walled off infection containing GAS bacteria and pus which may encroach upon the structures in the back of the throat or invade and rupture into deeper structures which may ultimately be fatal), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep)

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) facts

  • PANDAS is an acronym for "pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections."
  • It is a fairly recently described disorder (1990s).
  • An autoimmune response to a streptococcal infection causes PANDAS.
  • It is diagnosed if there is a history of abruptly developing a number of neuropsychiatric symptoms associated with a strep infection.
  • Medication and cognitive behavioral therapy are the primary treatments for PANDAS.

What is PANDAS?

PANDAS is an acronym which refers to "pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections." It is diagnosed clinically after a patient develops a number of behavioral and physical symptoms following a strep throat infection.

Is PANDAS common?

PANDAS is a rare condition. It is believed that approximately one in 2,000 children are affected, though the diagnosis may be overlooked due to some of the common symptoms associated with the disease. In fact, there are some researchers who recommend including PANDAS in a category of other disorders which include similar neuropsychiatric symptoms called CANS (childhood acute neuropsychiatric symptoms) or PANS (pediatric acute-onset neuropsychiatric syndrome).

What is the history of PANDAS?

PANDAS was described in the late 1990s after investigators identified a subgroup of children who developed a sudden onset of obsessive-compulsive disorder (OCD) symptoms, vocal and motor tics, and other behavioral changes. They identified that there was a common association in these children, and that was identified as a recent or active infection with a beta-hemolytic Streptococcus, the bacteria that causes strep throat. Researchers also identified a number of other infectious agents, known to cause significant auto-inflammatory reactions associated with neuropsychiatric symptoms, including influenza, varicella, and even Borrelia burgdorferi (Lyme disease), but the diagnosis of PANDAS is limited to streptococcal infections.

Medically Reviewed by a Doctor on 2/19/2015

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