OBJECTIVES: Pediatric Autoimmune Neuropsychiatric Disorders Associated with 
Streptococcal Infections (PANDAS) is a newly defined disease in neuropsychiatry 
and occurs with an autoimmune mechanism after Group A Beta Hemolytic 
Streptococcus (GABHS) infection. Tumor necrosis factor (TNF), encoded by TNF-α 
gene has an important role in the apoptotic mechanisms of autoimmune diseases. 
Recently, TNF-α polymorphisms and autoimmune/psychiatric disorders have been 
reported to be related. In this regard, we focused on to investigate a possible 
relation between the TNF-α gene promoter region-308 G/A and - 850 C/T 
polymorphisms and PANDAS.
MATERIALS AND METHODS: In this study, ages of PANDAS patient and control groups 
were ranging from 4 years to 12-year-old. Patient group includes childhood onset 
PANDAS patients (n = 42) and control group includes healthy children (n = 58). 
Diagnoses have been carried out according to Diagnostic and Statistical Manual 
of Mental Disorder (DSM-IV) criteria with Affective Disorders and 
Schizophrenia-Present and Lifetime (KSAD-S-PL) and Children Yale-Brown Obsessive 
Compulsive Scale Moreover, PANDAS criteria established by the American National 
Psychiatry Institute have been employed for diagnoses. For identifying 
polymorphisms; Polymerase Chain Reaction, Restriction Fragment Length 
Polymorphism and Polyacrylamid Gel Electrophoresis were used.
RESULTS AND DISCUSSION: For -308 polymorphism, 37 of 42 PANDAS patients' results 
and for -850 C/T polymorphism, 38 of 42 PANDAS patients' results were obtained. 
According to our statistical analysis there is a positive relationship between 
PANDAS patients for -308 G/A polymorphism but not for -850 C/T polymorphism. 
There is no positive relationship between -308 G/A polymorphism and 
antistrep-tolysin O (ASO) titers and no relationship between -850 C/T 
polymorphism and ASO titers. We found, however, positive relationship between 
genders of patients (boys) and the disease. According to our results, we propose 
that the AA polymorphism of -308 G/A polymorphism can be used as a molecular 
indicator for PANDAS.