Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is an autoimmune disorder presenting with obsessive compulsive disorder (OCD) and/or tics. PANDAS is believed to be caused by antibodies generated in response to a group A beta-hemolytic streptococcal (GAS) infection in genetically susceptible individuals. PANDAS is defined by five diagnostic criteria: (1) the presence of OCD and/or a tic disorder, (2) prepubertal symptom onset, (3) an abrupt onset of symptoms that are episodic in severity, (4) a temporal association between symptom exacerbations and GAS infections, and (5) the presence of neurological abnormalities (e.g., choreiform movements) during exacerbations. It has been reported that antibiotics and immunomodulatory therapies (plasma exchange and IVIG) were effective in lessening of symptom severity.
