Current Infectious Disease Reports

, Volume 12, Issue 2, pp 103–109 | Cite as

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS): a Controversial Diagnosis

  • Sheila Knupp Feitosa de Oliveira
  • Christina Feitosa Pelajo


Despite more than a decade of studying pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS), it is still not possible to confirm its existence and whether it is a poststreptococcal autoimmune disorder. Many controversies remain: the diagnostic criteria have not been validated, evidence of autoimmunity remains inconclusive, evidence of a genetic predisposition is weak, and streptococcal infections are common in childhood and could represent only a trigger of exacerbations of tics and obsessive-compulsive disorder. Patients who fit the PANDAS criteria appear to represent a subgroup of children with chronic tic disorder and/or obsessive-compulsive disorder who may experience symptom exacerbations after group A β-hemolytic streptococci infections; however, those infections are not the sole or even the most common antecedent of exacerbations. There is not enough evidence to support PANDAS as a unique clinical entity.


PANDAS Streptococcus Tics Obsessive compulsive disorder Autoimmunity 



No potential conflict of interest relevant to this article was reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sheila Knupp Feitosa de Oliveira
    • 1
  • Christina Feitosa Pelajo
    • 2
  1. 1.Division of Pediatric Rheumatology, Instituto de Puericultura e Pediatria Martagão GesteiraUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Division of Pediatric RheumatologyFloating Hospital for Children at Tufts Medical CenterBostonUSA

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