Quack Myth: PANDAS causes/is Autism


Like many myths that quacks believe or spread, real conditions that effect people are being touted at autism or a cause. PANDAS is no different. TACA and other quack organizations have their own ideas that do not stem from science on what it is and how to treat it. 

What is PANDAS

PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. A child may be diagnosed with PANDAS if obsessive compulsive disorder (OCD), tic disorder or both suddenly appear after a streptococcal (strep) infection. Most people with a strep infection make a full recovery. Some children develop sudden physical, psychiatric and neurological symptoms. Examples of these infections are strep throat or scarlet fever. The onset is usually dramatic and happen "overnight."

Cause

The cause of PANDAS is the strep bacteria. These are ancient bacteria that live in the human host to survive. It hides from the immune system as Lon gas possible. They hide themselves by putting molecules on their cell wall to disguise themselves as molecules found in the heart, joint, skin and brain. They do this by using molecular mimicry which is putting molecules no their cell wall to look identical to natural molecules in the body. 

This does not last forever as eventually the strep bacteria is discovered as a foreign material to the body and the immune system reacts to it and the the host molecules that were mimicked, causing an autoimmune reaction. This is an example of what cross reactive antibodies do. 

There are studies conducted at the National Institute of Mental Health (NIMH) and other reputable institutions that have shown these cross reactive antibodies target the brain. This causes OCD, tic, and other neuropsychiatric signs of PANDAS.

Development in Adults

PANDAS is classified as a pediatric disorder and typically appears from a get 3 up until puberty. Reactions to strep infections are rare after age 12 but it is possible for an adult to develop PANDAS. It is very unlikely and is not studied enough to make an accurate determination. 

Diagnosis

The diagnosis of PANDAS is a clinical diagnosis. This mean there are no lab tests that can diagnose this condition. Healthcare providers use diagnostic criteria for the diagnosis of PANDAS. Currently, clinical features of PANDAS is the only method of diagnosis. 

Diagnosis criteria:

  • presence of OCD, tic disorder or both
  • pediatric onset of symptoms (age 3 until peuberty)
  • Episodic course of symptom severity (dramatic ups and down in severity of OCD and tics, if children get another strep infection, symptoms will suddenly worsen again)
  • Association with group A beta hemolytic strep infection. This can be a positive throat culture for strep or history of scarlet fever
  • Association with neurological abnormalities, such as hyperactivity or unusually jerky movements that are involuntary. 
  • Abrupt onset or worsening of symptoms

Other Signs

  • signs of ADHD such as hyperactivity, inattention or fidgeting
  • separation anxiety
  • mood changes, such as irritability, sadness or emotional lability
  • trouble sleeping
  • nighttime bed wetting, frequent daytime urination or both
  • changes in motor skills, like handwriting
  • joint pain

If the symptoms have been present for more than a week, blood tests may be done to document a possible strep infection

JUST BECAUSE A CHILD HAS STREP OR HAS HAD STREP DOES NOT MEAN THEY HAVE PANDAS

Treatment

The best course of treatment is to treat any current strep infection the child might have. If there is a present strep infection, treat with antibiotics. This can be prescribed by a doctor. 

A throat culture should be done to confirm if there is a strep infection currently. If the culture is positive, a single course of antibiotics will get rid of any strep infection the child might have and this will allow the PANDAS symptoms to subside. 

If the culture is negative, the clinician should be sure that there isn't an occult (hidden) strep infection. This could be in the sinuses, anus, vagina or urethral opening of the penis. These hidden infections are rare but they have been reported to trigger PANDAS in some patients. In these cases, the course of antibiotic treatment may be needed for a longer period of time. 

Cognitive behavior therapy has been used to help control the OCD signs of PANDAS. A therapist will give the patient strategies to deal with OCD thoughts and fears. 

Antidepressants can help manage the OCD signs. They can be dangerous for children and kids with PANDAS have been more likely to have side effects from these medications. If the doctor recommends them, make sure that the right dose and side effects are understood. 

Bogus Study using IVIG

Susan Swedo and two other associate doctors conducted a study with 12 children she treated with Intravenous Immunoglobulin or  IVIG for PANDAS. This treatment has dangerous side effects and has not been approved for use with this condition. 

This study did not only test IVIG, other therapeutic approaches were used. There was no possibly way to know if this actually worked or other courses of treatment were effective. They were also receiving psychiatric care, anti obsessional medications and cognitive behavior therapy. This was not a well controlled study and no scientific discovery could have been made form this study. 

Susan Swedo also conducted the Chelation study that was canceled by NIMH due to the safety concerns of the lab rats. If it effected the rats the way it did, no way were they allowing it to be administered to human children. 

TACA and PANDAS

Upon researching what TACA has said about this syndrome, all the diagnostic criteria are the same as what NIMH has stated. The main difference is they cite Swedo as scientific fact, when her creditability has been shot a long time ago. 

"In atypical presentations, CaM kinase and anti-neuronal antibody testing can help to differentiate children with evidence of autoimmune encephalitis from those with tics, OCD, ADHD from other causes.  The most commonly abnormal parameters (in > 56%) are immune markers such as ANA.  Measuring other items such as zinc, magnesium, vitamin D and A and mitochondrial and thyroid markers may also be helpful in supporting appropriate treatments."


For treatments, they do list the treatments that are recommended by the NIMH but they also list a lot of unproven treatments:
  • Probiotics and prebiotics
  • xylitol and blisk12
  • many herbs
    • usnea
    • taiga
    • berbine
    • neem
    • oregano oil
    • cordyceps
    • thyme/oregano
    • colloidal silver
    • houttuynia
    • l-lysine
    • monolaurin
    • elderberry
    • olive leaf
    • glycyrrhiza
    • lemon balm
  • corticosteroid
  • IVIG
  • Plasmaphoresis- plasma transfusion that removes antibodies
  • intuximab
  • helminth therapy
  • ibuprofen
  • essential fatty acids
  • aloe
  • curcumin
  • flavonoids
  • SPM
  • CBD or hemp oil
  • vitamin D, A and C
  • Zinc
  • Resveratol
  • Melatonin
  • N acetyl Cysteine and glutathione
  • 5-htp
  • GABA
  • L-theanine
  • inositol
  • magnesium
  • L-MTHF
  • ashwagandha
  • motherwort
  • passionflower
  • mimosa bark
  • exercise
  • mediation and mantras
  • removal of anoids and tonsils
  • treatment of yeast, parasites, clostridia, mold, lyme and co infections
Sources:
https://www.nimh.nih.gov/health/publications/pandas/
https://www.webmd.com/children/what-is-pandas-syndrome
https://www.healthline.com/health/pandas-syndrome#treatment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340809/
https://tacanow.org/family-resources/immune-system-autism-and-pandaspans/



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