title: PANDAS: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections--an uncommon, but important indication for tonsillectomy.
abstract: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, also know as "PANDAS," is well described in the neurologic and psychiatric literature. PANDAS is associated with obsessive compulsive disorders (OCD) and tic disorders. The streptococcal infections may trigger an autoimmune reaction that exacerbates these conditions. Recurrent streptococcal tonsillitis is one of the recurrent infections associated with PANDAS. This paper reviews the case reports of two brothers, one with OCD and the other with a tic disorder, both of whom improved significantly after undergoing adenotonsillectomy for treatment of their recurrent tonsillitis. A review of the pathophysiology and current understanding of PANDAS is presented.
authors.affiliation: Department of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Heubi
authors.forename: Sally R
authors.initials: SR
authors.lastname: Shott
mesh_terms: D020274:Autoimmune Diseases of the Nervous System / Q000382:microbiology* / Q000601:surgery; D002648:Child; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000276:immunology / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications* / Q000601:surgery; D013297:Streptococcus pyogenes / Q000472:pathogenicity; D013981:Tic Disorders / Q000276:immunology / Q000382:microbiology; D014068:Tonsillectomy / Q000592:standards*; D014069:Tonsillitis / Q000382:microbiology* / Q000601:surgery*