Streptococcus bacteria are mainly known for their ability to cause pharyngitis. However, the range of phenomena that an infection with these pathogens can lead to is much broader. The streptococcus group bacteria can not only cause various infections, but can also in some way lead to psychiatric disorders in children, as they may be responsible for an entity known as PANDAS syndrome.
PANDAS stands for paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. The first descriptions of this syndrome were relatively recent, as it occurred in the late 1990s. The reason that for a long time PANDAS synd rome was not distinguished in medical classifications may be that the condition is not common: according to statistics, it is encountered in one in two thousand children.
Causes of PANDAS syndrome
The primary cause of PANDAS synd rome in a child is a history of infection caused by beta-haemolytic streptococci. However, infection with this bacterium alone is not the cause of the symptoms that develop in the course of this entity. Streptococci are known for the fact that their antigens can become similar to those present in the cells of the patient in question. The consequence of this is that the immune system - somehow 'thinking' that it is attacking the cells of a pathogenic micro-organism - has a detrimental effect on the body's normal cells. Thus, a seemingly trivial tonsillitis may end in glomerulonephritis or rheumatic fever. If the immune system affects nerve cells, PANDAS syndrome may result.
Why some children develop PANDAS syndrome after a streptococcal infection and others do not is still unknown. However, there are certain conditions whose existence increases the risk of developing this entity in a child burdened with them. Among these are:
- having a mother with some autoimmune disease,
- frequent, recurrent streptococcal infections in the child,
- a family history of rheumatic fever.
Psychiatric problems after angina: what are the symptoms of PANDAS syndrome?
Diagnosis of PANDAS syndrome is not straightforward - this is due to the fact that its symptoms are also present in many other conditions, such as Tourette's syndrome or Sydenham's chorea. The complaints associated with this syndrome can take on a variety of forms. Patients generally experience primarily a variety of psychiatric disorders. They may present with features of obsessive-compulsive disorder (OCD), as well as symptoms from the ADHD spectrum. They may experience personality changes, separation anxiety and significant irritability and mood disturbances.
Other problems, such as sleep disturbances and tics (which can range from motor to vocal tics), can also besymptoms of PANDAS syndrome. Children who previously did not have a learning disability may suddenly develop difficulties with writing or counting. Another complaint that may also occur in a child with PANDAS syndrome is bed-wetting.
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As can be seen from the above description, a child with PANDAS syndrome may be misdiagnosed - for example, their symptoms may suggest OCD or ADHD. There are, however, certain criteria that should lead to the correct diagnosis of PANDAS syndrome, such as the sudden onset of the symptoms described above. In addition, the symptoms usually appear shortly after a streptococcal infection, and may worsen during a subsequent streptococcal infection, and then decrease in intensity once the infection is cured. It is also important to note that PANDAS syndrome is only diagnosed in paediatric patients - the condition and its associated symptoms must have occurred before the patient's 18th birthday to be diagnosed.
