It’s estimated that 1 to 3 percent of children fit criteria for
Obsessive-Compulsive Disorder (OCD) and 10 to 25 percent of
school-age children will develop tics or related
neuropsychiatric disorders. Pediatricians and researchers now
question if the onset of these disorders could be related to
routine childhood strep infections. Here, Robert Fuhlbrigge, MD,
PhD, assistant in Medicine and attending in Pediatric
Rheumatology at Children’s Hospital Boston, explains the
possible connection. Pediatric Autoimmune Neuropsychiatric
Disorders Associated with Streptococcal Infections (PANDAS) are
neurological disorders associated with common Group A-Beta-
hemolytic streptococcus (GABHS) infections. The theory is that
the normal immune response to strep bacteria becomes misdirected
and attacks the brain, specifically the basal ganglia. This
hypothesis, termed molecular mimicry, is familiar to physicians
as the etiology of cardiac valve damage and Sydenham’s chorea in
acute rheumatic fever (ARF). The question is whether