PANS has multiple etiologies and disease mechanisms. PANDAS is a subset of PANS that requires a temporal relationship with Group A strep.

What Causes PANS?

PANS can be triggered by infections, metabolic disturbances, neurological issues, psychosocial stress, and other inflammatory reactions. It is a clinical condition defined by the sudden encephalitic-like onset of obsessive-compulsive symptoms and/or severe eating restrictions and at least two concurrent cognitive, behavioral, or neurological symptoms.

PANS can be triggered by infections, neurological and metabolic disturbances, psycho-social stress, and other inflammatory reactions. Infectious triggers include upper respiratory infections, influenza, mycoplasma pneumoniae, and Lyme borreliosis, among others. A PANS diagnosis does not require the identification of the specific trigger. 

PANDAS is triggered specifically by Streptococcus Pyogenes, better known as Group A Strep (GAS). PANDAS symptoms may start during or right after an active infection, but they can start a month or two after the GAS infection has resolved.  Not all patients with GAS have acute pharyngitis. GAS is not limited to the throat; infections may be found in the perianal area, the skin or the sinuses.

Researchers are working to understand how GAS and other triggers result in neuropsychiatric disorders. Current research is focused on understanding the relationships among immune system function, the blood-brain barrier, and genetics.


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