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Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)

Shari A. Schrack, CRNP, MSN and Jennifer Seidenberg, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) most commonly present as obsessive-compulsive disorder (OCD) and/or tic disorder dev...

DIAGNOSIS

HISTORY

  • The diagnosis of PANDAS is a clinical diagnosis.

  • Diagnostic criteria (1)

    • Sudden or worsening presence of OCD or tic disorder symptoms

    • Age of onset between 3 years and puberty

    • Abrupt onse...

TREATMENT

GENERAL MEASURES

  • Antibiotics indicated specifically for the treatment of acute GABHS infections

  • Symptomatic treatment of OCD/tics with cognitive-behavioral therapy and/or selective serotonin r...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Primary care or pediatric infectious disease for recurrent episodes of GABHS infection

  • Pediatric psychiatry

  • Pediatric neurology

  • Children enrolled in clinical trials ...

REFERENCES

1
Pabst C, Subasic K. PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Am J Nurs. 2020;120:32–37.
2
Sigra  S, Hesselmark...

ADDITIONAL READING

  • Chiarello  F, Spitoni  S, Hollander  E, et al. An expert opinion on PANDAS/PANS: highlights and controversies. Int J Psychiatry Clin Pract.  2017;21(...

CODES

ICD10

  • B95.0 Streptococcus, group A, causing diseases classd elswhr

  • D89.89 Other specified disorders involving the immune mechanism, not elsewhere classified

  • F95.9 Tic disorder, unspecified

  • F42 Obses...

CLINICAL PEARLS

  • Consider testing for acute GABHS infection in children with abrupt onset of OCD symptoms or tics.

  • Prophylactic antibiotics and/or immunomodulatory therapy to treat PANDAS is not recomme...

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