Diagnostic Approach to Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS): A Narrative Review of Literature Data.

Adriana Prato,Renata Rizzo,Mariangela Gulisano,Carmelo M Vicario,Rita Barone,Miriam Scerbo

doi:10.3389/fped.2021.746639

Abstract

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are clinical conditions characterized by the sudden onset of obsessive–compulsive disorder and/or tics, often accompanied by other behavioral symptoms in a group of children with streptococcal infection. PANDAS-related disorders, including pediatric acute-onset neuropsychiatric syndrome (PANS), childhood acute neuropsychiatric symptoms (CANS), and pediatric infection triggered autoimmune neuropsychiatric disorders (PITANDs), have also been described. Since first defined in 1998, PANDAS has been considered a controversial diagnosis. A comprehensive review of the literature was performed on PubMed and Scopus databases, searching for diagnostic criteria and diagnostic procedures of PANDAS and related disorders. We propose a test panel to support clinicians in the workout of PANDAS/PANS patients establishing an appropriate treatment. However, further studies are needed to improve our knowledge on these acute-onset neuropsychiatric conditions.

Highlights

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) was first described by Swedo et al in a group of 50 patients with an acute, sudden onset of obsessive–compulsive disorder (OCD) and/or tics, often accompanied by attention deficit/hyperactivity, separation anxiety, oppositional behaviors, and emotional lability, in the context of a previous streptococcal infection [1]
> control = control > control > control = control > control = control = control > control > control > control > control terms: “Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections,” “Pediatric acute-onset neuropsychiatric syndrome,” “PANDAS,” “pediatric acute-onset neuropsychiatric syndrome (PANS)” combined with “diagnosis,” “laboratory tests,” “diagnostic criteria,” to capture a broad range of potential articles
All patients meeting diagnostic criteria for PANDAS or PANS should have a series of laboratory tests: complete blood cell count with manual differential, indicator for liver and kidney disease, inflammatory markers such us erythrocyte sedimentation rate (ESR) and Creactive protein (CRP), metabolic panel, and urinalysis [12, 13]

Summary

Introduction

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) was first described by Swedo et al in a group of 50 patients with an acute, sudden onset of obsessive–compulsive disorder (OCD) and/or tics, often accompanied by attention deficit/hyperactivity, separation anxiety, oppositional behaviors, and emotional lability, in the context of a previous streptococcal infection [1].

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