PANDAS coexisting with gastrointestinal and cerebellar manifestation

This case report highlights a rare condition known as PANDAS (Pediatrics Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), which is characterized by sudden-onset neuropsychiatric symptoms following a streptococcal infection. The report also describes the unusual occurrence of cerebellitis, an uncommon neurological manifestation involving inflammation of the cerebellum, along with symptoms of vomiting and cerebellitis in a 9-year-old patient. The patient exhibited sudden onset of obsessive-compulsive symptoms, tics, stomach pain, and signs of intestinal blockage, which led to cerebellar dysfunction upon neurological examination. Laboratory tests confirmed a recent streptococcal infection, suggesting a diagnosis of PANDAS, while imaging studies revealed inflammation in the cerebellum and intestinal obstruction. This case presents a challenge to our understanding of the pathophysiological processes underlying PANDAS and its relationship with gastrointestinal and cerebellar symptoms. The treatment plan included immunomodulatory therapy, antibiotics, and surgical intervention for the intestinal obstruction, which led to a gradual improvement in symptoms. The report underscores the importance of considering atypical manifestations of PANDAS and adopting a multidisciplinary approach for precise diagnosis and effective management in complex situations.