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Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a disease primarily affecting children, with exceptions. According to the PANDAS Network, it affects 1 in 200 American children. They report that 11% are children under 3, 69% are between 4 and 9, and 19% are between 10 and 13. There is an additional statistic that is broad and includes adults, that 1% of those with PANDAS are 14 or older.

PANDAS is directly linked to streptococcal infections, often called strep throat, which can affect anyone at any age, including those in adulthood. While there is very little research studying the possibility of PANDAS disease in adults, it can occur.

PANDAS in Adults Explained

PANDAS is a syndrome that leads to psychiatric and neurological symptoms. Some researchers believe it is an autoimmune disorder in which a person’s immune system attacks areas in the brain that can lead to mental health disorders, such as obsessive-compulsive disorder (OCD), tics, or eating disorders.

PANDAS is typically described as the sudden appearance of acute mental health symptoms after someone has had the strep virus. 

PANDAS Causes in Adults

There isn’t one single factor that causes someone to experience PANDAS. While the strep virus is a direct link, it is considered a trigger, not a single cause. 

When infections enter the body, the immune system activates, sending inflammation to find the pathogens, destroy them, and flush them out. Some people have immune systems that will mistake healthy cells for dangerous pathogens and, unfortunately, attack them. Inflammation may occur in areas like the central nervous system, including the brain.

There may also be genetic factors that contribute to the development of PANDAS. For example, many people with the disorder have family members with autoimmune diseases or a long history with the strep virus.

PANDAS occurs when someone acquires a bacterial infection, usually from the strep virus. The infection triggers the immune system, mistakenly attacking healthy cells, causing drastic, sudden changes in physical and mental health.


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PANDAS Symptoms in Adults

Observable physiological and behavioral changes occur seemingly overnight. In a short time, someone may develop the following:

  • Obsessive-compulsive disorder symptoms, such as fear of germs, rituals, and repetitive behaviors.
  • Verbal or physical tics, such as grunting or jerky body movements.
  • Extreme anxiety, like fear or phobias, panic attacks, or excessive worry.
  • Severe depression, including suicidal ideations, uncontrollable crying, or prolonged sadness.
  • Uncontrollable anger, where someone may break or throw objects.
  • Sleep disturbances like insomnia.
  • Weight loss due to a change in eating behaviors, such as restrictive eating.
  • Deterioration of academic or work performance, especially handwriting and math skills.
  • Unusual changes in personality and behavior, like bedwetting, sensory problems, or regressing developmentally.

Doctors That Treat PANDAS in Adults

Any adult showing signs of PANDAS should visit an infectious and rare disease physician. They are specialists with extra years of education and experience in treating PANDAS. 

To find a doctor specializing in rare diseases, visit directories of international organizations, like the International Lyme and Associated Diseases Society. Choose a doctor based on qualifications, even if that means traveling outside the country.

Seeking treatment from a doctor who does not specialize in PANDAS means you risk being misdiagnosed, which can lead to symptoms worsening. Most doctors assessing an adult will reject the idea that an adult can have PANDAS. They think only children who have yet to reach puberty get the disease. In reality, adults may meet the criteria.

You may also prolong the process of getting the correct diagnosis. For example, when your doctor refers you to another doctor, and they refer you to someone else, the referrals continue until someone finally sends you to an infectious and rare disease doctor. Specialists know the proper way to diagnose and treat PANDAS.

Diagnosing PANDAS in Adults

The diagnostic criteria that infectious and rare diseases doctors follow include the following:

  • OCD, tics, or other symptoms of PANDAS.
  • Age, even those over the age of 14.
  • Symptoms occur suddenly and can often be narrowed to a specific day or time because it is unusual and life-altering.
  • Symptoms may come and go, but they seem to explode and exacerbate to a point that interferes with academic, professional, personal, and social functioning.
  • Streptococcal infection was present at some time before the appearance of symptoms.
  • Abnormal results of neurological exams.

Specialists further diagnose someone as mild, moderate, or severe PANDAS. For mild cases, symptoms last a few hours a day and interfere with how someone functions at home, school, or work. Moderate cases inhibit someone’s functioning up to 75% of their waking hours. Severe cases incapacitate someone with PANDAS, with symptoms affecting them up to 100% of their waking hours.

Treating Adults with PANDAS

Rare and infectious disease specialists have advanced treatments and equipment to perform procedures safely in their clinics. Treating PANDAS means eliminating all traces of an infection from a person’s blood and overall system.

PANDAS protocols are customized to meet your unique symptoms and situation. One crucial part is to discover and treat the infection’s true source. For most, the source will be the strep virus. In rarer cases, someone may have Lyme disease or a coinfection.

Protocols may also include the following:

  • Intravenous antibiotics.
  • Therapeutic plasma exchange is a popular treatment for PANDAS. This method involves removing blood from an infected person and replacing it with healthy, donated plasma.
  • Immunotherapy involves lowering auto-antibodies to stop neurodegeneration and neurotransmitter disorders.
  • Immunoglobulin therapy boosts the immune system to treat antibodies.
  • Methods to regenerate multiple types of cells, including neurological. Doctors may use stem cells or neurogenerative peptide therapies.
  • Removing stressors, heavy metals, mold, and any other toxins present.

Don’t Wait to Get Treatment

Time can be an enemy when trying to figure out if you have PANDAS and get proper treatment. Don’t wait to contact a specialist.

Consider traveling outside the United States, Canada, and the UK to Mexico to meet with a top clinic, Lyme Mexico. Learn more about Lyme disease or schedule an evaluation. We can discuss your symptoms and the alternative treatment options that work.


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