Behavior goes ‘haywire’: How strep throat may trigger OCD, anxiety in children

[Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, or PANDAS] is as puzzling for researchers as it is for the families that struggle with it. Scientists studying the condition propose that the string of psychiatric symptoms [including OCD and anxiety] is triggered by infection with Group A Streptococcus, one of the most common childhood illnesses. In some children, a faulty immune response to the infection may mistakenly attack brain cells, causing behavior to go haywire.

But researchers have yet to nail down which brain cells are harmed. And it’s not clear why countless children get strep, yet so few develop PANDAS symptoms. With so much uncertainty about how strep could affect the brain, some experts doubt whether PANDAS is a separate disorder from OCD and whether it’s truly triggered by strep. Amid the debate, families searching for help get mixed messages.

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For particularly severe cases, clinicians may turn to a more invasive treatment aimed at resetting a malfunctioning immune system. The procedure, intravenous immunoglobulin, or IVIG, is an infusion of antibodies stripped from the blood of thousands of healthy donors. The goal is for the new antibodies to bind to and disable the patient’s harmful ones.

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