Local physician raises awareness of PANDAS

For young children, an innocuous sore throat could be a sign of PANDAS (pediatric autoimmune neuropsychiatric disorders), a condition that a Solana Beach-based doctor has been centering his practice around.

According to the PANDAS Network, a group that provides advocacy and support, PANDAS is caused by a “misdirected immune response,” which leads to inflammation in a child’s brain that results in symptoms such as obsessive-compulsive disorder, anxiety, tics and changes in personality.

“After you see patients like this for a few weeks, the degree to which it simply takes over the family’s life, especially in the more severe cases, it’s just so moving,” said Dr. Patrick Whelan, a pediatric rheumatologist at the David Geffen School of Medicine at UCLA.

Whelan, who now resides in Solana Beach and Los Angeles, has worked with more than 80 families that have been affected by PANDAS over the past two years. He first began seeing patients affected by PANDAS more than 10 years ago at Massachusetts General Hospital in Boston, which now has an extensive research program devoted to the condition and its underlying causes.

Whelan said that part of his work is raising awareness about PANDAS.

“A lot of people are skeptical about it, and I think reasonably so,” he said, adding that PANDAS-related symptoms such as tics and OCD are relatively common in children who don’t have PANDAS.

In his current role as an assistant professor of pediatrics at the Geffen School of Medicine, Whelan provides care for children with arthritis and related issues. When he arrived at UCLA about two years ago, he said he encountered a greater demand from PANDAS patients looking for help than he expected.

Whelan said themes in “Peter Pan,” captured in a Gerald Scarfe cartoon from the New Yorker, relate to PANDAS.

(courtesy of Gerald Scarfe)

“There was this huge backlog of families that are affected with this,” said Whelan, adding that he might be the only physician in the region who formally sees PANDAS patients. “It’s basically taken over my practice.”

He said he’s worked with one mother who faces a “full-time job” raising her three children affected by PANDAS, with the anxiety, panic attacks and other symptoms they experience.

Whelan said three underlying problems experienced by children with PANDAS are not sleeping well, anxiety, and sensory processing problems that can lead them to being overly picky in the types of food they will eat or the clothes they wear, for example.

Before COVID-19 closed down entertainment venues across the country, Whelan saw a production of “Fly,” a musical inspired by “Peter Pan,” at the La Jolla Playhouse. He said he was “struck” by “how much the character Peter Pan illustrates what we’re up against with PANDAS.” Similar to real children affected by PANDAS, the production features children who are sensitive to danger, fearful about other people touching them and have active imaginations, he said. Peter Pan author J.M. Barrie, an advocate for children’s health, gave the Peter Pan copyright to a children’s hospital in London before he died.

Whelan said he works with schools, which sometimes have children who cause problems in class because of their PANDAS symptoms but have not been diagnosed yet.

“The specific message for families is that there are people out there who specialize in this kind of thing,” he said.