PANDAS Syndrome

Even mild winters like we experience see an uptick of seasonal illnesses. The fairly common Streptococcus pyocenes infection makes its rounds and can range from minor skin problems or sore throats to much more severe strep throat or scarlet fever. 

While most people make a full recovery, for some children, a scary syndrome can develop suddenly a few weeks after a strep infection and get worse quickly.

Despite its cute name, PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcus, is quite serious. Children between ages 3 and 12 who have had a strep infection within the last four to six weeks are most susceptible. Symptoms include sudden psychological and physical symptoms that are similar to obsessive-compulsive disorder and Tourette syndrome.

“PANDAS is an interesting, frustrating and chronic condition about which too many people and doctors are not well versed with,” says Dr. Prem Menon, founder of the Asthma, Allergy and Immunology Center in Baton Rouge, who is board certified in allergy, immunology and pediatrics.

The exact cause of PANDAS is unknown, but theories include immune reactions to strep bacteria confusing antibodies, specifically causing them to target the brain. “The main thing is to diagnose and treat strep immediately,” Dr. Menon says. “Don’t dilly dally or wait around.” Penicillin is the drug of choice to knock out the infection and hopefully avoid any strep complications. 

“The sudden onset of symptoms would be a red flag,” Dr. Menon says. “These symptoms occur within two-four weeks of strep throat, overnight, no warnings.” 

Dr. Menon treats a few patients with PANDAS, which is fortunately rare. One patient who suffered for years was able to get better after intravenous immunoglobulins treatments. By clearing the patient’s immune system with a megadose of IVIG every day for five days, Dr. Menon was able to improve her symptoms, which included tremendous separation anxiety and other mood alterations.

Receiving a diagnosis can be an uphill battle. “With rarer conditions like this, they don’t get diagnosed because pediatricians are busy seeing a lot of patients and don’t think about it,” Dr. Menon says. He encourages patients to be persistent and proactive with their health care providers.

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