Abstract

Sydenham chorea (SC), a major manifestation of rheumatic fever (RF), is thought to occur when antibodies directed against group A streptococcus (GAS) cross-react with epitopes on neurons of the basal ganglia. In earlier work with SC, Swedo and colleagues identified children who, in addition to chorea, presented with obsessive-compulsive behavior. A precipitous onset of childhood obsessive-compulsive disorder (OCD) after streptococcal pharyngitis was subsequently described that shared many similarities to SC but did not have chorea or clinical signs of RF such as arthritis and carditis. Swedo and colleagues termed this subtype of childhood-onset OCD, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

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