Streptococcal infection of the neck is a common childhood disease, but in a few children this bacterial infection can lead to alarming and lasting changes. Scientists are now starting to discern how it affects the brain.
In the case of children, the immune system reacts exaggeratedly to streptococcal infection. Photo: Archive
The story of Charlie Drury, from Illinois (US), illustrates the phenomenon. In November 2012, by his eight -year anniversary, the child was diagnosed with streptococcal infection. In the following weeks, his behavior has changed radically: he developed tics, severe anxiety, insomnia, hallucinations and refuse to eat. “I lost my child one day,” tells his mother, Kate Drury. After a month of searches, the doctors diagnosed: Pandas – autoimmune neuropsychiatric disorder associated with streptococcal infection, BBC notes.
What is pandas and why is it controversial
Pandas causes the sudden appearance of tics and symptoms of obsessive-compulsive disorder, accompanied by problems of behavior, pain, irritability and regress in cognitive or motor skills. Although rare – estimates suggest about 11,800 children annually – the condition is recognized by the World Health Organization and, more recently, by the American Pediatric Academy, although it remains controversial in some medical environments.
Research suggests that, in certain genetically predisposed children, the immune system exaggeratedly react to streptococcal infection and produce antibodies that attack their own tissues, including basal lymph nodes – brain region involved, decisions and emotional responses.
Recurrent symptoms and complex treatments
Pandas symptoms can occur suddenly and can disappear in a row, and then reappear after a new infection, be it streptococcal, influenza or even Covid-19. Treatment often includes antibiotics, anti -inflammatory and, in severe cases, intensive therapies such as intravenous immunoglobulins (IVIG) or plasma exchange.
“If the treatment starts early, the results can be very good”, says Jennifer Frankovich, pediatric rheumatologist in Stanford, USA. But many patients have difficulty accessing these therapies, either due to lack of specialists, or because of high costs and the reluctance of doctors to recognize the disease.
Charlie’s case is not singular. Many parents report similar dramas: sudden changes in behavior, repeated hospitalizations and years of treatments. Some families, such as Lulu Johnson, a little girl who died in 2021 after Pandas associated complications, choose to donate tissues for research, hoping to contribute to the discovery of more effective treatments.
Despite the progress, Pandas and its wider form, pans, remain insufficiently understood. “There is no clear test, and brain changes are subtle and difficult to see in the imaging”, say the specialists.
