E-ISSN 1858-8360 | ISSN 0256-4408
 

Case Report 


PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl

Amal Yousef Kentab.

Abstract
Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a rare recently recognised clinical syndrome with common presentations that include tics, Tourette’s-like syndrome or obsessive-compulsive disorder. It is associated with various behavioural and psychiatric manifestations in children, such as separation anxiety disorder, body dysmorphic disorder, and attention deficit hyperactivity disorder. Steroid responsive encephalopathy with autoimmune thyroiditis (SREAT) is a rare disorder in children associated also with various movement disorders and neuropsychiatric manifestations. The present report describes a previously healthy 10-year-old girl who presented with motor tics, visual hallucination, separation anxiety, and emotional liability. Her workup showed an evidence of Hashimoto’s thyroiditis on laboratory results, in addition to the elevation of antistreptolysin O titre (ASO). Based on this, a diagnosis of SREAT was made, and she was given courses of methylprednisolone with inadequate response. Then, the possibility of PANDAS was considered, and she responded to multiple courses of antibiotics with abate of symptoms after a course of intravenous immunoglobulin combined with monthly benzathine penicillin injections. To the best of our knowledge, this is the first reported case of PANDAS associated with autoimmune thyroiditis causing such diagnostic dilemma.

Key words: Paediatric neuropsychiatric disorder associated with streptococcal infection; PANDAS; Autoimmune disorder; Hashimoto`s encephalopathy; Streptococcal infection.


 
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How to Cite this Article
Pubmed Style

Kentab AY, . PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudan J Paed. 2019; 19(2): 149-155. doi:10.24911/SJP.106-1555859744


Web Style

Kentab AY, . PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. http://www.sudanjp.com/?mno=44669 [Access: February 24, 2020]. doi:10.24911/SJP.106-1555859744


AMA (American Medical Association) Style

Kentab AY, . PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudan J Paed. 2019; 19(2): 149-155. doi:10.24911/SJP.106-1555859744



Vancouver/ICMJE Style

Kentab AY, . PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudan J Paed. (2019), [cited February 24, 2020]; 19(2): 149-155. doi:10.24911/SJP.106-1555859744



Harvard Style

Kentab, A. Y. & (2019) PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudan J Paed, 19 (2), 149-155. doi:10.24911/SJP.106-1555859744



Turabian Style

Kentab, Amal Yousef, and . 2019. PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudanese Journal of Paediatrics, 19 (2), 149-155. doi:10.24911/SJP.106-1555859744



Chicago Style

Kentab, Amal Yousef, and . "PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl." Sudanese Journal of Paediatrics 19 (2019), 149-155. doi:10.24911/SJP.106-1555859744



MLA (The Modern Language Association) Style

Kentab, Amal Yousef, and . "PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl." Sudanese Journal of Paediatrics 19.2 (2019), 149-155. Print. doi:10.24911/SJP.106-1555859744



APA (American Psychological Association) Style

Kentab, A. Y. & (2019) PANDAS versus Hashimoto`s encephalopathy: a diagnostic dilemma in a Saudi girl. Sudanese Journal of Paediatrics, 19 (2), 149-155. doi:10.24911/SJP.106-1555859744





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