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PANS/PANDAS resources for the American Academy of Pediatrics – AAP

PANS/PANDAS FAST FACTS
FOR PEDIATRICIANS

The American Academy of Pediatrics (AAP) acknowledges PANS/PANDAS as syndromes characterized by abrupt onset of dramatic behavioral and neuropsychiatric symptoms in children.

Immediate action needed by the AAP to integrate the latest scientific findings and collaborate on best practices for PANS PANDAS.

Consider PANS/PANDAS when you see a patient with a sudden and dramatic onset of unwanted thoughts, fears, rituals, obsessive compulsive disorder, restrictive eating, and/or an overall abrupt decline in mental health.

Strep or other infections, such as Mycoplasma pneumonia, influenza, upper respiratory infections, or sinusitis, may be triggering the neurobehavioral changes and psychological distress.

PANS/PANDAS is treatable. Treatment is a three pronged approach that addresses the source (infections), the immune system dysfunction, and the symptoms.

PANS/PANDAS: SYMPTOMS & DIAGNOSING

Children with PANS have an abrupt and dramatic onset of:

  • OCD or Restrictive Eating Disorder
  • plus additional symptoms from at least 2 of the following categories:
  • Anxiety and/or separation anxiety
  • Emotional lability and/or depression
  • Irritability, aggression, and/or severe oppositional behaviors
  • Behavioral regression
  • Deterioration in school performance
  • Sensory or motor abnormalities (including tics)
  • Somatic signs and symptoms, including sleep disturbances or urinary frequency

PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a clinically defined disorder. Patients experience a sudden onset of obsessive-compulsive symptoms (OCD) and/or eating restrictions, along with acute deterioration in at least two of the symptom categories listed above. The syndrome is thought to be an immune reaction to a number of physiological stressors including Group A Streptococcal infection, Mycoplasma pneumonia infection, influenza, upper respiratory infections, sinusitis, Lyme, and psychosocial stresses. PANS has no age limitation.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) is a subset of PANS. PANDAS has five distinct criteria for diagnosis, including abrupt OCD or dramatic, disabling tics; a relapsing-remitting, episodic symptom course; young age at onset (average of 6–7 years); presence of neurologic abnormalities; and temporal association between symptom onset and Group A strep infection. The 5 criteria usually are accompanied by similar comorbid symptoms as found in PANS.

What causes PANDAS PANS?

TRADITIONAL OCD VS PANS/PANDAS

PANS/PANDAS differs from traditional childhood OCD in presentation and treatment options. PANDAS/PANS may be considered a form of Basal Ganglia Autoimmune Encephalitis.

WHAT RESOURCES CAN
HELP ME WITH MY PATIENT?

PANS/PANDAS Treatment Charts
The PANS/PANDAS treatment charts guide you through treatment considerations based on the symptom severity for mild, moderate, and severe cases.

Seeing Your First Child with PANDAS/PANS
“Seeing Your First Child with PANDAS/PANS”, by Margo Thienemann, MD, co-director of Stanford’s Immune Behavioral Health Clinic and the PPN Diagnostics and Therapeutics Committee, provides an overview and current theories, PANDAS/PANS symptoms and diagnostic criteria, workup recommendations, and expectations.

PANS Research Consortium Consensus Statement and Treatment Recommendations
The JCAP papers include details on PANS/PANDAS evaluation details and treatment options including antibiotics to remove the source of inflammation (strep or other infection), anti-inflammatories, IVIG, behavioral therapies, and more.

PANS/PANDAS Clinics
Pediatricians can diagnose PANS/PANDAS and implement the majority of treatments. There are a limited number of multidisciplinary care clinics available for more complex cases. Please note some clinics have strict criteria for seeing new patients due to high demand.

PANS/PANDAS Research Library
Review our Research Library for the latest studies on PANS/PANDAS.