PANDAS = Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

https://www.psychologytoday.com/us/blog/attention-please/201501/adult-pandas-seek-and-ye-shall-find

Jory Goodman M.D.
Attention, Please

Adult PANDAS: Seek and Ye Shall Find

PANDAS occurs in adults. Period. Is most of it new onset, or has it been there a long time, since childhood? Yes. Can one differentiate between the two? Not with any certainty in the preponderance of cases. Let’s ratiocinate for a moment. If an adult can acquire Rheumatic Fever or Glomerulonephritis after a strep infection, that adult can acquire PANDAS. If an adult can acquire Lyme disease, mycoplasma, and a myriad of viral infections, that adult can acquire PANDAS. If there is a flaw in this logic I missed it.

It has been a while since I posted anything on PANDAS. In that time I have diagnosed dozens of new cases of PANDAS in children, adolescents and, yes indeed, adults. A few actually came to see me to find out if they had PANDAS. They had read or heard about PANDAS and found me. Yet most had never heard of it.

The population is split between patients who had never been to a psychiatrist before, and those who had been to one, or many, with less than salutary results. The presenting complaints varied broadly; anxiety, panic, depression, ADHD, sleep difficulties, OCD, tics, Bipolar Disorder, ODD, headaches, fibromyalgia, medication side effects. And many more.

Why do I find so many PANDAS cases? Is it something in the air in Beverly Hills (well, that isn’t the best query)? Is there a cluster of cases in the area? No. It comes down to knowing when to look for certain things. If one does not know to look one never finds. If one knows to look, and looks, one often finds what is there! There are no conundrums here. There are a surfeit of undiagnosed cases of PANDAS throughout the populace and it is time for doctors to learn about it and to look for it. Even if one allows for the nature of my practice and reputation how can one solo psychiatric practice diagnose one to two new cases of PANDAS each week?

SIDEBAR: I have no idea how to put a sidebar in this blog so consider this to be one, or a long parenthetical. In Medical School the first lecture on psychiatry always addresses the obligation of the psychiatrist to look for or rule-out underlying organic (medical) factors that may cause or exacerbate a psychiatric problem or presentation. This is reiterated in residency. And in the first chapter of every general psychiatry textbook. It doesn’t suggest that every patient be examined or “worked-up” for every conceivable diagnosis known to man. Where is the problem?

Here is the part where I will be called boasting and conceited.

https://www.psychologytoday.com/us/blog/attention-please/201501/adult-pandas-seek-and-ye-shall-find
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Dear RM Agents and Readers,

I wouldn't call this guy boasting and conceited; I'd call him hitting the mark!!! Make sure and visit the link as it has some of the ills that can bring this on.

Many Blessings,
CrystalRiver