Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections(PANDAS) is a hypothetical diagnosis whereby a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders symptoms are supposedly caused by group A beta-hemolytic streptococcal (GABHS) infections.[1] The proposed link between infection and these disorders is that an initial autoimmune reaction to a GABHS infection produces antibodies that interfere with basal ganglia function, causing symptom exacerbations. It has been proposed that this autoimmune response can result in a broad range of neuropsychiatric symptoms.[2][3] The PANDAS hypothesis was based on observations in clinical case studies at the US National Institutes of Healthand in subsequent clinical trials where children appeared to have dramatic and sudden OCD exacerbations and tic disorders following infections.[4]
OCD and tic disorders are hypothesized to arise in a subset of children as a result of a post-streptococcal autoimmune process.[5][6][7] The PANDAS hypothesis is unconfirmed and unsupported by data, and two new categories have been proposed: PANS (pediatric acute-onset neuropsychiatric syndrome) and CANS (childhood acute neuropsychiatric syndrome).[6][7] The CANS/PANS hypotheses include different possible mechanisms underlying acute-onset neuropsychiatric conditions, but do not exclude GABHS infections as a cause in a subset of individuals.[6][7] PANDAS, PANS and CANS are the focus of clinical and laboratory research but remain unproven.[5][6][7]Whether PANDAS is a distinct entity differing from other cases of tic disorders or OCD is debated.[8][9][10][11] PANDAS is a subset of the pediatric autoimmune neuropsychiatric syndrome (PANS) hypothesis.[12]
https://en.wikipedia.org/wiki/PANDAS
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