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Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS): a Controversial Diagnosis

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Abstract

Despite more than a decade of studying pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS), it is still not possible to confirm its existence and whether it is a poststreptococcal autoimmune disorder. Many controversies remain: the diagnostic criteria have not been validated, evidence of autoimmunity remains inconclusive, evidence of a genetic predisposition is weak, and streptococcal infections are common in childhood and could represent only a trigger of exacerbations of tics and obsessive-compulsive disorder. Patients who fit the PANDAS criteria appear to represent a subgroup of children with chronic tic disorder and/or obsessive-compulsive disorder who may experience symptom exacerbations after group A β-hemolytic streptococci infections; however, those infections are not the sole or even the most common antecedent of exacerbations. There is not enough evidence to support PANDAS as a unique clinical entity.

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Authors and Affiliations

  1. Division of Pediatric Rheumatology, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Av. Bruno Lobo, 50 Fundão, Rio de Janeiro, 21490-591, Brazil

    Sheila Knupp Feitosa de Oliveira

  2. Division of Pediatric Rheumatology, Floating Hospital for Children at Tufts Medical Center, 800 Washington Street, Box #190, Boston, MA, 02111, USA

    Christina Feitosa Pelajo

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  1. Sheila Knupp Feitosa de Oliveira
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  2. Christina Feitosa Pelajo
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Correspondence to Sheila Knupp Feitosa de Oliveira.

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de Oliveira, S.K.F., Pelajo, C.F. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS): a Controversial Diagnosis. Curr Infect Dis Rep 12, 103–109 (2010). https://doi.org/10.1007/s11908-010-0082-7

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