The question of PANDAS in adults.

Abstract

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.

• Authors: S M Bodner, S A Morshed, B S Peterson
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 49 Issue 9 Pg. 807-10 (May 01 2001) ISSN: 0006-3223 [Print] United States
• PMID: 11331090 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-Bacterial Agents
• Antibodies, Bacterial

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Antibodies, Bacterial (immunology)
• Autoimmune Diseases (diagnosis, immunology, microbiology)
• Brain (microbiology, pathology)
• Humans
• Magnetic Resonance Imaging
• Male
• Obsessive-Compulsive Disorder (diagnosis, microbiology)
• Pharyngitis (drug therapy, microbiology)
• Severity of Illness Index
• Streptococcal Infections (diagnosis, microbiology)
• Time Factors
• Tourette Syndrome (diagnosis)