S2 E19: Rheumatic Clues To Understanding the PANDAS/PANS Puzzle -- A Conversation with Dr. J. Patrick Whelan

Untangling PANDAS & PANS: Conversations about Infection-Associated, Immune-Mediated Neuropsychiatric Disorders

Untangling PANDAS & PANS: Conversations about Infection-Associated, Immune-Mediated Neuropsychiatric Disorders
S2 E19: Rheumatic Clues To Understanding the PANDAS/PANS Puzzle -- A Conversation with Dr. J. Patrick Whelan
Oct 26, 2025 Season 2 Episode 19

A sore throat that ends in compulsions, tics, and a child who suddenly can’t sleep or attend school sounds improbable—until you hear a pediatric rheumatologist walk through the biology. Dr. J. Patrick Whelan of UCLA sits down with Dr. Susan Manfull, Executive Director of The Alex Manfull Fund, to unpack how infections and the immune system can collide with brain function, producing abrupt-onset OCD, motor and vocal tics, restricted eating, and anxiety that look psychiatric but respond to immunomodulatory treatments. Drawing from a variety of sources, including the history of rheumatic fever, the Lancefield classification of streptococci, and modern cases of Multisystem Inflammatory Syndrome in Children (MIS-C). Dr. Whelan explains why PANDAS and PANS challenge old categories and demand a broader clinical lens.

We dive into innate versus adaptive immunity, what “autoinflammatory” and “autoimmune” really mean, and why so many affected kids also show signs of immunodeficiency. If routine tests like ASO and anti–DNase B come back normal, does that rule out strep’s role? Not necessarily. Whelan shares how expanded antibody panels, trial responses to antibiotics or anti-inflammatories, and careful history-taking can reveal an immune trigger that standard workups miss. He also outlines the practical steps that matter right now: restore sleep, get moving, stabilize nutrition, and build companionship—simple interventions that reduce pain amplification and calm a dysregulated nervous system. Finally, we talk about why “listening to the patient” often illuminates key clues to understanding the case.  

If you care about pediatric mental health, infection-associated neuroimmune disorders, or how medicine evolves when data and curiosity meet, you’ll find both science and solace here.

If this resonates, follow the show, share with someone who needs it, and leave a review to help more families and clinicians find these insights.

Disclaimer: The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Credits: Music by Kingsley Durant from his "Convertible" album

To learn more about PANDAS and PANS and The Alex Manfull Fund, visit our website: TheAlexManfullFund.org

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Episode Artwork S2 E19: Rheumatic Clues To Understanding the PANDAS/PANS Puzzle -- A Conversation with Dr. J. Patrick Whelan 1:25:18 Episode Artwork S2 E18: My Conversation with Dr. Mikki Tal about How She Is Revolutionizing Our Understanding of Infection-Associated Chronic Illness 1:15:18 Episode Artwork S2 E17: Sheilah Gauch Offers Eight Tips for Students with PANS and their Parents on How to Successfully Transition to College...or Anywhere Else 1:19:28 Episode Artwork S2 E16: Dr. Andrew Baumel: One Pediatrician's Journey to Include Mild Cases of PANDAS/PANS into his Everyday Practice 46:02 Episode Artwork S2 E15: Science Under Siege: A conversation with Dr. Uğur Akcan and Dr. Dritan Agalliu about PANDAS Research, NIH Cuts, and the Power of Community 1:31:57 Episode Artwork S2 E14: When Everything Changes: Jen's Journey with PANS/PANDAS and the Fight to Be Believed 58:04 Episode Artwork S2 E13: Understanding the Role of a Psychologist in PANDAS and PANS: A Conversation with Dr. Sarah O'Dor 1:15:03 Episode Artwork S2 E12: The Neuropathology of PANDAS/PANS: Dr. Brent Harris Talks about the POND Brain Bank 1:16:43 Episode Artwork S2 E11: Physician-Scientist Herb Lachman, MD, Talks about Recent Genetic Observations in PANS: DNA Damage Response Genes 1:13:42 Episode Artwork S2 E10: Dr. Juliette Madan Explains the Importance of Epidemiological Research on PANDAS & PANS 46:49 Episode Artwork S1 E9: Dr. Warris Bokhari Vows to Make Healthcare Equitable One Unjust Insurance Denial at a Time 1:17:13 Episode Artwork S1 E8: Dr. Pawel Kiela Discusses the Gut Microbiome, Microglia, and PANDAS 1:19:01 Episode Artwork S1 E7: Dr. Tim Ubhi Talks about Treating PANDAS/PANS in the UK at his new London PANS Clinic 1:25:58 Episode Artwork S1 E6: The Story Behind AB2105, California's Bill to Require Insurance Coverage for PANDAS/PANS Treatment 50:49 Episode Artwork S1 E5: Earl Harley, MD Talks About How Otolaryngologists Can Assist in the Treatment of PANDAS 44:53 Episode Artwork S1 E4: Beth Latimer, MD Discusses How the Understanding of PANDAS has Progressed: It is Not Solely a Pediatric Disorder 1:06:31 Episode Artwork S1 E3 Part 1: Dr. Shannon Delaney Talks About What Do Tick-Borne Diseases Have to Do with PANS? 56:36 Episode Artwork S1 E3 Part 2: Dr. Shannon Delaney Talks About What Do Tick-Borne Diseases Have to Do with PANS? 29:33 Episode Artwork S1 E3 Part 3: Dr. Shannon Delaney Talks About What Do Tick-Borne Diseases Have to Do with PANS? 13:22 Episode Artwork S1 E2: The Intersection of Strep, Intractable OCD, Psoriasis, and IL-17: A Conversation with Kyle Williams, MD, PhD and Andrew 1:06:04 Episode Artwork S1 E2 Bonus: The Intersection of Strep, Intractable OCD, Psoriasis, and IL-17: Continued conversation with Kyle Williams, MD, PhD and Andrew 15:54 Episode Artwork S1 E1: Lauren Breithaupt, PhD, Talks About The Immunological Basis of Eating Disorders and PANDAS/PANS 50:15 Episode Artwork S1 E1 Bonus: PANDAS/PANS Advocacy Day on Capitol Hill - Join us on April 12, 2024 42:32