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OmniSekhmet , 25 Sep 2008

Rheumatic Fever/Strept Throat & OCD connection? (PANDAS)

I am new to this site and have many similarities to what has been described here. I am 43, female, and have been picking since I was young. I have Keratosis pilaris, a "common skin condition in which a protein in the skin called keratin forms hard plugs within hair follicles" (quoted from medical definitions). My mom used to pick these off me and my sisters when we were little. I don't blame her for this, or for my now OCD skin picking, even if it contributed to this. I remember pulling out the hairs on my knees when I was young, too. For a time I picked my scalp, badly, for over a year. I don't pick my scalp now, but I have scars, open sores & lots of scabs or bloody spots all over my arms (this past year is the first time my forearms have been a real target), and my buttocks, and my legs. This past month I have gone very wild picking my calves, then I started on my tummy, breasts, and inner thighs, more than I used to. Then, yesterday I started on my face! I have always been able to limit my face to only what a normal would pick if they pretty much never pick. Stupid me! I have my niece's bridal shower on Saturday, and her wedding next Wednesday, and here I am with sores all over my body and even infection on my face (I have occasional flare-ups of infection pockets in a few areas of my face. One is right smack dab in the middle of my big fat nose, and one next to the inside of my eyebrow- right where everybody looks!!!) Anyway, Today I have decided to wage war on this demon of mine! I am so compelled and so obsessed and can't stop even when I am late for something and people are waiting on me and I am telling myself STOP! over &over, I just... can't! But now, I have found this site & info so I am really going to make a real effort to STOP! and at the very least, get back in major control so I can stop. Well, I have a real question for everyone. Have you had Rheumatic Fever or lots of cases of Strept throat? I did have Rheumatic Fever when I was 5, and I had Strept throat on & off until my tonsils were removed at age 16. There is a possible link between this and OCD. I found this article called PANDAS THE OCD/STREP CONNECTION, written by Marc W. Reitman, MD. It intrigued me. PANDAS an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Please reply! Thanks! OmniSekhmet
4 Answers
September 28, 2008
I have always had regular, but not too frequent cases of Strept throat, about 1-2 times a year, but my tonsils have not been removed. And I also pick, I squeeze and pick bleeding sores, sometimes using the tweezers (but I am going to stop). I remember doing somewhat similar things as a child.
September 29, 2008

In reply to by Noscubs

Thanks for posting your replay, Noscubs. Do you notice if your picking gets worse when you get Strept throat and then is gone when you are better, only to get worse again when you get Strept throat again? Or does it get worse at times but gradually gets better, you know, waxes & wanes? Here is an excerpt from the article I read by By Marc W. Reitman, MD: "The National Institute of Mental Health group has recently published their findings of 50 children, following them over a 2-year course. The results indicate that these children have typical OCD symptoms but atypical associated features, which would include: * The onset of symptoms is sudden and dramatic such that parents can frequently recall the date of onset. The usual onset of OCD is more gradual. * This group of children has an earlier age of onset of symptoms than compared to the usual onset. * PANDAS children are seen to have complete remissions of symptoms between episodes of symptoms. The non-PANDAS OCD symptoms usually follow a waxing and waning course. * The presence of accompanying neurological signs such as tics, hyperactivity, or choreiform movements (irregular spasmodic involuntary movements of the limbs or facial muscles) further distinguishes this subgroup of children with OCD. * Other symptoms can include emotional lability (over reactions to minor events), separation anxiety, nighttime fears and oppositional behaviors. * Symptoms worsen following a strep infection." See, if this is the cause, the treatment is different than conventional OCD treatments. The article says, "Treatments for this type of OCD have included plasma exchange (a filtering of the plasma eliminating antigen/antibody complexes), intravenous immunoglobulin (IVIG), steroids or antibiotics. There is an ongoing study exploring the chronic use of antibiotics to prevent re-infection by strep, which could theoretically avoid further episodes of OCD. The results of this study could help guide clinicians in the treatment of this subgroup of OCD. However, these are no current recommendations that antibiotics should routinely be administered as a formal treatment." I've been 'picking' my mom's brains for my childhood symptoms. I don't know if my symptoms followed the pattern of "remissions of symptoms between episodes of symptoms" or if they waxed & waned. I am sure my picking (and other OCD symptoms) mostly wax & wane now, but maybe they do because my OCD became more typical OCD because of my stress over the years. I am so much worse as an adult (getting worse all the time) than when I was young. Wouldn't it be great if we could get rid of this!?!
September 29, 2008
Do you mean like tonsilitus? i had tonsilitus once or twice every year really badly when i was little, i've had them removed but i still get it on the tissue where tonsils were. i wonder why theres a connection between them. iv picked at myself since i was little, i never thought much of it as a kid, my parents just thought it was a bad habitt hat i didnt stop doing it because i didnt have the will power. its good to realise that its not just about having will power, to stop i need to understand what it is and why i do it
September 29, 2008

In reply to by agnesuk

Yes, tonsilitis, but caused by the Strept throat bacteria specifiacally. It is diagnosed with a throat culture and treated with antibiotics, whereas viral tonsilitis has to 'run it's course'. Read my reply to Noscubs. And, the reason OCD could be caused by Strept is stated in the article by Marc W. Reitman, MD as this, "Over the last ten years, there has appeared a mounting body of evidence that suggests there is a small subgroup of individuals whose childhood onset Obsessive-Compulsive Disorders may have been triggered by streptococcal throat infections. This association of an infectious cause with a neurobiological disorder may also be true for tic disorders, such as Tourette's Disorder, Trichotillomania (compulsive hair pulling), and possibly Attention Deficit Hyperactivity Disorder. These conclusions were drawn from research conducted by Drs. Susan Swedo, Judith Rappaport, and their associates at The National Institute of Mental Health. During the late 1980's, they observed that children with Sydenham's Chorea, the neurobiological manifestation that follows bouts of Rheumatic Fever, had an unusually high percentage of OCD symptoms, including both obsessions and compulsions. Rheumatic Fever is caused by Group A Beta hemolytic streptococcal bacteria, commonly known as strep throat. In a vulnerable subgroup of children, the immune response to the bacteria goes awry, causing the antibodies to mistakenly identify the basal ganglia (an area deep within the brain) as foreign bodies. The basal ganglia then become inflamed as a result of this "mistaken identification." This chain reaction is what is known as an autoimmune response, when the immune system misidentifies an individual's own cells as foreign. Noting that 70% of Sydenham's Chorea patients have OCD symptoms, Drs. Swedo and Rappaport conducted research of children with sudden onset of OCD, looking for a casual relationship between a strep infection and OCD symptoms...." I have heart valve damage from Rheumatic Fever, caused the way this article states the basal ganglia is attacked by the immune system. I believe it is possible my brain, the basal ganglia or other areas, even, could have been affected as well. I need as much info as possible to take to my Dr and have him help me figure out a better treatment for me. I am on an antidepressant and Vyvanse (I have chronic depression, dysphoria, ADD, insomnia, alcoholism, as well as OCD). I really am a mess. My childhood wasn't traumatic, no abuse that I can recall. I have close relationships with my whole family. My parents aren't divorced. And, although some of my siblings have been treated for depression on & off , and some of their children were treated for ADD, as well as my own son, and some of my relatives have committed or attempted suicide, and a few have addictive personalities, a couple alcoholics.... I seem to be the only one with so many problems, and so bad! I'll start a new thread in the next few days with my childhood symptoms and my current ones. Then we can all compare our demons (LOL-not!) Thanks for your post, agnesuk. My family thought/think the same thing about my willpower & it just being a bad habit. I sure hope we can all help each other here.

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