PANDAS: a new disease?
OBJECTIVE
To establish the diagnostic criteria for PANDAS and to analyze the existing evidence regarding its etiopathogenesis, treatment and prophylaxis.


METHODS
Review of the scientific literature through a MEDLINE search carried out between 1989 and 2006.


RESULTS
The diagnostic criteria for PANDAS were established nearly 10 years ago, but a lot of controversy still exists over the actual existence of this new pediatric disease. The name of this new disease, supposedly of poststreptococcal etiology, derives from an acronym that stands for pediatric autoimmune neuropsychiatric disease associated with streptococcal infection. Tics and obsessive-compulsive symptoms are the major clinical signs of the disease, which develop after streptococcal infections, probably through autoimmune mechanisms. Even though these neuropsychiatric symptoms are common in rheumatic chorea, whose etiology is also poststreptococcal, the classic choreiform movements and other symptoms of rheumatic fevers are absent in PANDAS. The use of antimicrobial and immunologic therapy has been investigated and considered feasible in some cases.


CONCLUSIONS
Further research is still necessary in order to answer the question posed in the title of this article. In the meantime, the identification of tic disorders and obsessive-compulsive disorders in children should include the possibility of PANDAS, seeking to provide evidence of previous streptococcal infection.
de Oliveira
Sheila Knupp Feitosa
SK
Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. sheila_knupp@hotmail.com
D000004:Abbreviations as Topic; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D013290:Streptococcal Infections / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology; D020323:Tics / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control