PANDAS anorexia nervosa--endangered, extinct or nonexistent?

OBJECTIVE: Substantial evidence exists for the concept of pediatric autoimmune neuropsychiatric disorders associated with streptoccoccal infection (PANDAS) such as some cases of obsessive-compulsive disorder and tics/Tourette's syndrome. More recently PANDAS-AN has been described. The aim of this article is to provide a critical review of this concept.

METHOD: The literature was searched using Medline, Psychinfo, and Google.

RESULTS: There is some evidence for the entity of PANDAS-AN but this is considerably limited by a wide range of methodological problems, including the seemingly low prevalence, the lack of clarity in diagnostic criteria, and the lack of specificity in the diagnostic tests. Innovative treatment approaches hold promise but require further evaluation.

CONCLUSION: Further research into PANDAS-AN, using more clearly defined and consistent diagnostic criteria is needed, given the potential for enhancing the understanding of the pathogenesis of AN and for more effective treatments.