It is called Pandas ( Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). Research is just beginning. The Group A streptococcus bacteria seem to trigger an autoimmune reaction (where antibodies produced by the infection interfere with neuronal cells) that brings a sudden onset of obsessive-compulsive disorder (OCD), tics and other neurological changes, including anxiety, irritability, hyperactivity, anorexia and urinary problems in children.
Some say that infections don’t trigger PANDAS. In 2009 a review found that the link between streptococcal infections and tic disorders remained unclear.
PANDAS is currently not listed as a diagnosis by the International Statistical Classification of Diseases and Related Health Problems (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Those who think PANDAS exists hypothesize that it is caused by an autoimmune disorder that results in a combination of tics, obsessions, compulsions, and other symptoms that may be severe enough to qualify for diagnoses such as chronic tic disorder, OCD, and Tourette’s. The cause is thought to be similar to that of Sydenham’s chorea, which is known to result from childhood Group A streptococcal (GAS) infection leading to the autoimmune disorder acute rheumatic fever of which Sydenham’s is one manifestation. Sydenham’s disease is characterized by rapid, uncoordinated jerking movements affecting primarily the face, feet and hands.
Like Sydenham’s, PANDAS is thought to involve autoimmunity to the brain. PANDAS is not associated with other symptoms and forms of acute rheumatic fever, such as inflammation of the heart.
The treatments are experimental. A single study of PANDAS patients showed that immunomodulatory (A drug which has an effect on the immune system) therapy might work. According to the NIMH and the Advisory Board experimental treatments based on the autoimmune theory such as intravenous immunoglobulin (IVIG) or plasma exchange should be reserved for severely ill patients and should not be undertaken outside of formal clinical trials.
For those of us with autoimmune diseases it should come as no surprise that an infection such as Strep could trigger an autoimmune disease. It would be our hypothesis that even if symptoms don’t show up right away, they may show up 30 years down the road. At the time the patient may say, “I remember when I had that step infection.”