PANDAS: Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococci and its Intricacy with Rheumatic Heart Disease - Case Report

  • Meenakshi Swathi Kumaraswamy Junior Resident, Paediatrics, Madras Medical College (ICH & HC), Tamil Nadu, India.
  • Leema Pauline Cornelius Professor and Head, Paediatric Neurology, Madras Medical College (ICH & HC), Tamil Nadu, India.
  • B Shanthi Professor and Head, Paediatric Psychiatry, Madras Medical College (ICH & HC), Tamil Nadu, India.
Keywords: PANDAS, Rheumatic Heart Disease, Group A Streptococci, OCDs


Paediatric Autoimmune Neuropsychiatric Disorder Associated with group A Streptococci (PANDAS) is a term used to describe certain neuropsychiatric manifestations which have a tendency to relapse with recurrent Group A streptococcal infection. The molecular mimicry hypothesised as a cause for this infection is the same as that of Rheumatic Heart Disease (RHD) which has not yet been proved. Hence there is a perpetual conflict of interest for the need of continuous antibiotic prophylaxis and their duration for secondary prevention in the paediatric population. Here, we discuss about a 9-year-old boy who presented with choreoathetoid movements and mitral valve involvement. He was treated for neuropsychiatric as well as cardiac complications following streptococcal infection under the suspicion of RHD. Due to poor compliance, the child had relapses of involuntary movements in the intermittent period which is consistent with the criteria of PANDAS. Hence high index of suspicion should be considered for all the children with features of insignificant valvular abnormalities in endemic populations during their subsequent follow-up for signs/symptoms of PANDAS.

How to cite this article:
Kumaraswamy MS, Cornelius LP, Shanthi B. PANDAS: Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococci and its Intricacy with Rheumatic Heart Disease - Case Report. Postgrad J Pediatr Adol Med. 2022;1(2):30-32.


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