Increasing evidence suggests a potential role for the immune system in OCD pathogenesis. Children with sudden onset of OCD and/or motor tics and evidence of recent streptococcal infection may meet criteria for pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) (Williams and Swedo 2015). Early studies suggested that this subset of patients may develop postinfectious immune-mediated damage to the basal ganglia, as described for Syndenham's chorea, a neuropsychiatric complication of rheumatic fever (RF) (Williams and Swedo 2015).
