{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T17:36:46Z","timestamp":1772645806593,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is recognized as a significant causative element in the emergence of childhood-onset obsessive-compulsive disorder (OCD) and movement disorders, including tic disorders, and choreiform movement. It is associated with various behavioral and psychiatric manifestations in children, such as separation anxiety disorder, body dysmorphic disorder, attention deficit hyperactivity disorder, and eating disorders. We describe a unique case of progressive weight loss in a previously healthy 13-year-old child who had a sudden and dramatic onset of refusal to eat, induction of vomiting, emotional liability, anxiety disorder, and OCD over 6 months following fever and pharyngitis. His workup showed an elevation of antistreptolysin O (ASO) titer with a negative throat swab. PANDAS was considered. His irritability improved after a course of antibiotics, and abatement of all symptoms and progressive weight gain occurred after a course of intravenous immunoglobulin (IVIG) followed by monthly benzathine penicillin injections. This report could help to increase awareness among physicians, highlight the importance of early diagnosis, and promote treatment of PANDAS among patients who present with a combination of eating disorders and OCD.<\/jats:p>","DOI":"10.3389\/fpsyt.2025.1704296","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:29:43Z","timestamp":1769524183000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A unique case of food restriction and OCD diagnosed as PANDAS and a review of the literature"],"prefix":"10.3389","volume":"16","author":[{"given":"Amal Y.","family":"Kentab","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University","place":["Riyadh, Saudi Arabia"]},{"name":"Department of Pediatrics, King Saud University Medical City, King Saud University","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolan","family":"Bassrawi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Saud University Medical City, King Saud University","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.272.22.1788","article-title":"Sydenham\u2019s chorea: a model for childhood autoimmune neuropsychiatric disorders (clinical conference)","volume":"272","author":"Swedo","year":"1994","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1542\/peds.93.2.323","article-title":"Kiessling L: Speculations on antineuronal antibody-mediated neuropsychiatric disorders of childhood","volume":"93","author":"Swedo","year":"1994","journal-title":"Pediatrics"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.146.2.246","article-title":"High prevalence of obsessive-compulsive symptoms in patients with Sydenham\u2019s chorea","volume":"146","author":"Swedo","year":"1989","journal-title":"Am J Psychiatry"},{"key":"B4","first-page":"364A","article-title":"Mannheim G, Leonard H: Antineuronal antibodies in Sydenham\u2019s chorea and obsessive-compulsive disorder (abstract)","volume":"29","author":"Swedo","year":"1991","journal-title":"Pediatr Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199503000-00015","article-title":"Case study: a new infection-triggered, autoimmune subtype of pediatric OCD and Tourette\u2019s syndrome","volume":"34","author":"Allen","year":"1995","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.155.2.264","article-title":"Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases","volume":"155","author":"Swedo","year":"1998","journal-title":"Am J Psychiatry"},{"key":"B7","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4172\/2161-0665.1000113","article-title":"From research subgroup to clinical syndrome:modifying the PANDAS criteria to describe PANS (pediatric acute-onset neuropsychiatric syndrome)","volume":"2","author":"Swedo","year":"2012","journal-title":"Pediatr Therapeut"},{"key":"B8","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1128\/CMR.13.3.470","article-title":"Pathogenesis of group A streptococcal infection","volume":"13","author":"Cunningham","year":"2000","journal-title":"Clin Microbiol Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000179056.54419.5e","article-title":"PANDAS with catatonia: a case report. 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