|What are the acronyms P.A.N.S., P.A.N.D.A.S. AND P.I.T.A.N.D?
Dr. Cunningham's laboratory continues its research studies in the mechanisms of the auto-antibodies that may play a role in these diseases. If you wish to donate to this crucial research, please see our Research & How to Help page.
P.A.N.S. is Pediatric Acute-onset Neuropsychiatric Syndrome. It encompasses P.A.N.D.A.S., which is Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections and P.I.T.A.N.D., which is Pediatric Infection Triggered Autoimmune Neuropsychiatric Disorders. PANDAS is a subset of PITAND. Dr. Susan Swedo, Chief of Pediatrics & Developmental Neuroscience Branch at the National Institute of Mental Health (NIMH) and her research team identified a subtype of OCD in children during the 1990's that is triggered by infection. Streptococcal infection has been most studied; however, any infection can trigger this condition.
PANDAS-PITAND is autoimmune in nature, meaning that something is malfunctioning in the patient’s immune system. The process is similar to what happens in Rheumatic Fever, except that the brain is being attacked instead of the heart, causing encephalitis (inflammation of the brain), particularly in the basal ganglia region. A gene is activated following an infection (usually Group A beta-hemolytic Streptococcus or GABHS), causing the immune system to respond inappropriately. Antibodies attack the brain, leading to a myriad of challenging symptoms for the patient as well as their family. Overnight manifestation is the hallmark sign.
Once the autoimmune process is initiated, the gene must be turned off to resolve the condition and presenting symptoms. If caught very early in the process, antibiotics may be sufficient and steroids/NSAIDS have been used in some patients with some success to decrease brain inflammation. In other cases, treatment modalities such as plasma exchange or Intravenous Immune Globulin (IVIG) therapy may be used to achieve remission. Further research is needed.
Unconfirmed infection does
not rule out PANDAS-PITAND.
• Obsessions and/or Compulsions
• Sydenham’s Chorea and/or Choreiform Movements
• Emotional lability, including rages
• Personality changes
• Age regression
• Separation Anxiety
• Oppositional Defiance Disorder
• Tactile/Sensory Defensiveness
• Major Depression
• Marked deterioration in handwriting and/or math skills.
• Urinary urgency or frequency/enuresis
Since 1973, Dr. Madeleine Cunningham's research has focused on streptococci and immunology. The autoimmune component of this condition has been a focus of her lab since 2001. PANDAS-PITAND manifests with a variety of symptoms, including OCD (Obsessive Compulsive Disorder) and/or tic disorders such as Tourette syndrome. The classic presentation is overnight manifestation of symptoms following an infection.
While Dr. Cunningham’s studies have shown that CaM Kinase activation occurs when particular GABHS antibodies react with neuronal tissue in PANS and Sydenham chorea patients, more research is needed to determine the mechanisms behind some patients who have high CaM Kinase II levels, but few symptoms. Further research would help us understand what is different in the immune systems of these patients and perhaps lead to better treatment options for all patients who suffer from these diseases.
Because PANDAS-PITAND conditions have similar presentations and because auto-immune diseases can be complex, it is important to evaluate for co-infections and other conditions, such as tick-borne diseases such as Lyme disease, Ehrlichiosis and Babesia (standard blood tests may not reveal what more sensitive labs might), Mycoplasma Pneumoniae and others, in addition to Group A Strep. Consult your child’s doctor for further information and evaluation if you suspect PANDAS-PITAND.PANDAS-PITAND Awareness & Research Support is partnering with Dr. Madeleine Cunningham’s lab to increase awareness and raise funds through donations for products featuring the Awareness Ribbon. All proceeds support Dr. Cunningham’s PANDAS-PITAND research to help our children with accurate diagnosis and treatment.
PANDAS-PITAND Awareness Ribbon
The GREEN ribbon represents the healthy future life we want for the victims of PANDAS-PITAND.
The HANDS represent us walking alongside our children.
PURPLE is for Auto-immune Awareness.
SAWTOOTH edges are for the episodic nature of this condition & its impact on the lives of children and their families.
| PANDAS-PITAND Awareness & Research Support (PPARS)
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