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Can OCD be an autoimmune disease?

Written by: Lucine Avanesian


Although our immune system is generally thought of as defending us from outside invaders such as bacteria, viruses, and other germs, it may become confused and attack our own body. It is said that we suffer from an autoimmune disorder when this happens.


It is suspected that childhood autoimmune neuropsychiatric conditions associated with streptococcal infections or OCD type 'PANDAS' are caused by an infection of the same bacteria that causes strep throat and scarlet fever. When the immune system of the child battles the strep infection, it becomes confused and a region of the brain called the basal ganglia begins to strike.


While changes in a variety of brain areas are associated with symptoms of OCD, basal ganglia abnormalities have been associated with symptoms of OCD.


Of course, strep throat is a common infection and the PANDAS type of OCD will not develop in all children who develop this infection.



How Is the PANDAS Form of OCD Diagnosed?


About 25% of children with OCD have the PANDAS subtype. The PANDAS form of OCD has a few key symptoms that let doctors distinguish it from more typical forms of childhood OCD. For example: The symptoms of regular OCD develop slowly whereas the onset of the PANDAS form of OCD is rapid. The PANDAS form of OCD occurs in close association with a strep infection; however, regular OCD can occur at any time. Confirmation of a strep infection is usually done using a throat culture and/or blood test for strep antibodies. Unlike regular OCD, children with the PANDAS form of OCD usually have involuntary movements of the arms, legs, and face.

The PANDAS form of OCD usually develops between the ages of 3 and before puberty.


How Is PANDAS OCD Treated?

Although regular OCD is usually treated with medication, such as selective serotonin reuptake inhibitors (SSRIs) or cognitive behavioral therapy, the PANDAS form of OCD can require different treatment.


If the PANAS form of OCD is suspected, the first line of treatment is a round of antibiotics to knock out the strep infection. Sometimes more invasive procedures such as a plasma exchange are necessary to remove harmful antibodies from the bloodstream. Plasma exchange usually involves going to the hospital.


Although most children will recover following treatment with antibiotics, sometimes symptoms of OCD can remain. These residual symptoms may be an effective treatment with standard treatments for regular OCD such as medications or psychotherapy.



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