JAMA, Journal of the American Medical Association, Otolaryngology–Head & Neck Surgery recently published the Case Report “The Role of Tonsillectomy in the Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS)” by Drs. Demesh, Virbalas, and Bent.
This Case Report “reported symptom improvement in comparison with treatment with antibiotics alone, including those with no response to antibiotics” and “four of the 9 had complete resolution (of PANDAS symptoms) after tonsillectomy”.
Only the abstract is available for free and can be read at:
Currently, tonsillectomies are not a standard form of treatment for PANDAS children. There have been mixed reviews both in the medical community and within the parent community. Some have seen marked improvement with PANDAS symptoms and a lowering in the number of strep infections. Others have shared that the tonsillectomy did not help and symptoms temporarily worsened post surgery.
If a tonsillectomy is considered by an experienced ENT, parent feedback has suggested a treatment course of antibiotics prior to surgery and antibiotics post surgery. Requesting the tonsils be biopsied post surgery may also show whether strep, staph, or other bacteria was hiding in the tonsillar crypts.
Additional research on this topic is in development. Tonsil and Adenoid Analysis conducted by Drs. Beth Latimer, Neurology and Earl Harley, ENT (Georgetown University) will include a research paper on autoimmune cell findings found in some PANDAS/PANS children’s tissues. Expected publication in 2015.
Other Relevant Research:
PANDAS Syndrome: a new tonsillectomy indication? (2008)
Tonsillectomies and Adenoidectomies Do Not Prevent the Onset of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococcus (2013)