Volume 29, Issue 164, October 2025

Treatment methods for Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections Syndrome: A literature review

Weronika Buczek^1♦, Mikołaj Wiśniewski¹, Jolanta Wiśniewska², Agata Brzyska³, Tomasz Kucharski⁴, Greta Steć³, Sandra Prolejko⁵, Błażej Gajęcki³, Justyna Kopala⁶, Magdalena Pawlak³

¹Pope John Paul II Independent Public Regional Hospital in Zamość, ul. Aleje Jana Pawła II 10, 22-400 Zamosc, Poland
²Medical University of Lublin, Al. Racławickie 1, 20-059 Lublin, Poland
³Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
⁴Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
⁵Medical University of Lodz, Kościuszki 4, 90-419 Lodz, Poland
⁶University Clinical Hospital No.2 of the Medical University of Lodz, Żeromskiego 113, 90-549 Łódź, Poland

^♦Corresponding author
Weronika Buczek, Pope John Paul II Independent Public Regional Hospital in Zamość, ul. Aleje Jana Pawła II 10, 22-400 Zamosc, Poland

ABSTRACT

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a clinical syndrome of sudden onset occurring in children before puberty in which obsessive-compulsive symptoms and/or tics and other behavioural disorders are present following documented group A streptococcal (GAS) infection. PANDAS is a rare disease that is controversial with its diverse symptomatology and still-uncovered pathogenesis. The review presents different procedures of treatment, including pharmacological, non-pharmacological, and surgical procedures. PANDAS syndrome treatments are the subject of an increasing amount of research. Pharmacological therapies include penicillin and macrolide antibiotics, corticosteroids, and selective serotonin reuptake inhibitors. Cognitivebehavioural therapy, which has a proven effect in the treatment of obsessivecompulsive disorder (OCD), is also receiving increasing attention. Additionally, studies on intravenous immunoglobulin, plasma exchange, and plasmapheresis are underway. Treatment of PANDAS syndrome is developing all the time. More randomised trials are needed to establish precise diagnostic criteria and therapeutic recommendations for this disease entity.

Keywords: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS); tics; obsessive-compulsive disorder (OCD)

Medical Science, 2025, 29, e208ms3658

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DOI: https://doi.org/10.54905/disssi.v29i164.e208ms3658

Published: 14 October 2025