PANDAS: Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococci and its Intricacy with Rheumatic Heart Disease - Case Report
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.
Swedo SE, Leonard HL, Garvey M, Mittleman B, Allen AJ, Perlmutter S, Lougee L, Dow S, Zamkoff J, Dubbert BK. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections clinical description of the first 50 cases. Am J Psychiatry. 1998;155:264. [PubMed] [Google Scholar]
Swedo SE, Leckman JF, Rose NR. From research subgroup to clinical syndrome: modifying the PANDAS criteria to describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatr Ther. 2012;2. [Google Scholar]
Snider LA, Sachdev V, MacKaronis JE, Peter MS, Swedo SE. Echo cardiographic findings in the PANDAS subgroup. Pediatrics. 2004;114(6):748-51. [PubMed] [Google Scholar]
Srivastava M, Shankar G, Tripathi MN. Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS) a case report. J Clin Diagn Res. 2011;5:1298-300.
Murphy ML, Pichichero ME. Prospective identification and treatment of children with paediatric autoimmune neuropsychiatric disorder associated with Group A streptococcal infection (PANDAS). Arch Pediatr Adolesc Med. 2002;156:356-61. [PubMed] [Google Scholar]
Perlmutter SJ, Leitman SF, Garvey MA, Hamburger S, Feldman E, Leonard HL, Swedo SE. Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood. Lancet. 1999;354:1153. [PubMed] [Google Scholar]
Budman C, Coffey B, Dure L, Gilbert D, Juncos J, Kaplan E, King R, Kurlan R, Lowe T, Mack K, Mink J, Schlaggar B, Singer H; Touretteâ€™s Syndrome Study Group. Regarding â€œantibiotic prophylaxis with azithromycin or penicillin for childhood-onset neuropsychiatric disordersâ€. Biol Psychiatry. 2005;58(11):917. [PubMed] [Google Scholar]