PANDAS syndrome. A case report
Monika Cybertowicz, Marta Półgrabia

The aim of the study is to present a case of a girl with PANDAS syndrome, who was multiply misdiagnosed by paediatricians before the final diagnosis was made. The patient was a 15‑year‑old girl, who attended junior high school. The girl was referred to the children’s psychiatrist because of fatigue, asthenia, school performance deterioration, social and emotional difficulties at school and home. She reported to the doctor’s appointment with her mother, who was worried about her daughter’s health status which deteriorated in spite of the previous somatic treatment. The girl was examined by psychiatrist and psychologist. The data obtained during anamnesis as well as conversations, medical advice, psychological consultations suggested obsessive‑compulsive disorder as a presumptive diagnosis. After additional tests, especially detailed anamnesis, physical examination and paediatric treatment record cards, PANDAS syndrome was diagnosed. The prospective anamnesis and rapid, dramatic onset of the symptoms were the main factors contributing to the final diagnosis. Simultaneously, a connection between the onset of the disease and streptococcal infection, which was confirmed during hospitalisation, was shown. The above data indicate that detailed anamnesis and confirmation of infection are of great importance during PANDAS syndrome diagnosis. This may indicate that a separate group of PANDAS syndrome exists. A directed diagnosis of obsessive‑compulsive disorders should be considered particularly in the case of a sudden or fierce onset of symptoms related to the upper respiratory tract infection. Neuro‑immunological factors involved in the aetiology of the disorder should be considered in the case of a medical history suggesting rheumatic fever in the family members.