The question of PANDAS in adults.
BACKGROUND
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a well-defined cause of obsessive-compulsive disorder in children. However, they have not been described or fully investigated in adults newly diagnosed with obsessive-compulsive disorder.


METHODS
We describe an adult with onset of obsessive-compulsive disorder at 25 years of age after a severe antibiotic-responsive pharyngitis. He was evaluated with multiple psychiatric rating scales for obsessive-compulsive disorder and Tourette's syndrome, as well as with serologic assays and radiologic studies.


RESULTS
In all respects except age our patient fulfilled established criteria for PANDAS. Assays for antibodies to group A beta-hematolytic streptococci, serum D8,17 lymphocytes, antistriatal (neuronal) antibodies, and anticytoskeletal antibodies all supported the hypothesis that a poststreptococcal process was active. Magnetic resonance imaging was abnormal and is described.


CONCLUSIONS
The findings suggest that this patient's illness is similar to PANDAS in presentation and that poststreptococcal disease may result in adult-onset obsessive-compulsive disorder.
Bodner
S M
SM
Department of Psychiatry, Yale University Medical School, New Haven, Connecticut 06519, USA.
Morshed
S A
SA
Peterson
B S
BS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D001921:Brain / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000382:microbiology*; D010612:Pharyngitis / Q000188:drug therapy / Q000382:microbiology; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013997:Time Factors; D005879:Tourette Syndrome / Q000175:diagnosis
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial