Anti-brain antibodies in PANDAS versus uncomplicated streptococcal infection

Pediatr Neurol. 2004 Feb;30(2):107-10. doi: 10.1016/S0887-8994(03)00413-2.


The objective of this study was to assess brain involvement through the presence of antineuronal antibodies in Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) and in uncomplicated active Group A streptococcal infection. We compared serum antibrain antibody to human basal ganglia sections assessed by indirect tissue immunofluorescence in two groups: a PANDAS group, comprised of 22 patients (mean age 10.1 years; 20 male, 2 female) who met strict National Institutes of Mental Health diagnostic criteria for PANDAS and had clinically active tics or obsessive-compulsive disorder, or both; and a GABHS control group consisting of 22 patients (mean age 9.1 years; 15 mol/L, 7 female) with clinical evidence of active Group A beta-hemolytic streptococcal (GABHS) infection confirmed by throat culture and elevated antistreptolysin O titers but without history or clinical evidence of tics or obsessive-compulsive disorder. We observed positive anti-basal ganglia staining (defined as detectable staining at 1:10 serum dilution) in 14/22 patients in the PANDAS group (64%) but only 2/22 (9%) in the GABHS control group (P < 0.001, Fisher's exact test). These results suggest that antibrain antibodies are present in children with PANDAS that cannot be explained merely by a history of GABHS infection.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Antibody Formation*
  • Antistreptolysin / biosynthesis
  • Brain / immunology*
  • Brain / metabolism
  • Child
  • Deoxyribonucleases / immunology
  • Female
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / enzymology
  • Mental Disorders / immunology*
  • Neurons / immunology
  • Streptococcal Infections / complications
  • Streptococcal Infections / enzymology
  • Streptococcal Infections / immunology*
  • Streptococcus agalactiae / immunology*


  • Antistreptolysin
  • Deoxyribonucleases
  • deoxyribonuclease B