Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections-presentation and challenges to care in a Nigerian community

Amalachukwu O. Odita; Kenneth N. Okeke; Sylvia T. Echendu; Nkiru V. Agu; Christian C. Ifezulike

doi:10.18203/2349-3291.ijcp20251874

Authors

Amalachukwu O. Odita Department of Paediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka https://orcid.org/0000-0002-2695-9370
Kenneth N. Okeke Department of Paediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka
Sylvia T. Echendu Department of Paediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Teaching Hospital Nnewi, Awka https://orcid.org/0000-0003-4582-2502
Nkiru V. Agu Department of Paediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka
Christian C. Ifezulike Department of Paediatrics, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Amaku, Awka https://orcid.org/0000-0001-5968-5671

DOI:

https://doi.org/10.18203/2349-3291.ijcp20251874

Keywords:

Autoimmune, Neuropsychiatric disorders, Children

Abstract

To present a case series of paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), highlighting the clinical presentation, diagnostic process, and management strategies. PANDAS is characterized by the sudden onset of neuropsychiatric symptoms such as obsessive-compulsive disorder (OCD) or tic disorders following streptococcal infections. The condition poses diagnostic and therapeutic challenges due to its complex presentation and overlap with other neuropsychiatric disorders. This case series highlights three children in a Nigerian community diagnosed with paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Presentations included the abrupt onset of obsessive-compulsive behaviour, tics, and neuropsychiatric disturbances linked to prior streptococcal infections. A detailed clinical evaluation, laboratory testing, timely diagnosis, and individualized multidisciplinary management approach, including antibiotics, immunomodulatory therapies, and psychosocial support, resulted in significant clinical improvement and successful management of PANDAS. These cases underscore the importance of considering PANDAS in children with abrupt neuropsychiatric symptoms post-streptococcal infection and illustrate the benefits of a comprehensive management approach to optimize outcomes.

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