The acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated
with streptococcal infections) has been assigned to a subgroup of patients
experiencing pediatric onset obsessive-compulsive symptoms and tics as a result
of autoimmune response to group A β-hemolytic streptococcal infection. It has
been hypothesized that an immune process initiated by infection affects the
basal ganglia and causes neuropsychiatric symptoms. In cases with severe
neuropsychiatric symptoms, the use of treatment strategies that interrupt the
autoimmune process responsible for the pathogenesis of PANDAS, such as
therapeutic plasmapheresis or intravenous immunoglobulin, has been proposed. In
this paper, we discuss the effect of plasmapheresis treatment in 4 adult cases
of obsessive-compulsive disorder and tic disorder triggered by streptococcal
infections.