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PANS-PANDAS, case report
Francy Tatiana Villabona1, Gisela Hernández1, Víctor Manuel Mora-Bautista1
1Clínica San Luis, Bucaramanga, Santander, Colombia.
Insights
Childhood acute neuropsychiatric syndrome (CANS) and pediatric acute-onset neuropsychiatric syndrome (PANS) are often missed diagnoses. Evaluating children with OCD or eating disorders for CANS/PANS is crucial for timely treatment and reduced morbidity.
Area of Science:
- Pediatric Neurology
- Neuropsychiatry
- Autoimmune Disorders
Background:
- Childhood neuropsychiatric syndromes, including PANS and CANS, have evolved conceptually since 1980.
- Despite recognition for over two decades, these conditions remain frequently undiagnosed by healthcare professionals.
Observation:
- A case study of a 6-year-old girl presenting with acute onset of eating refusal.
- The patient met diagnostic criteria for PANS-PANDAS and exhibited a relapsing-remitting course.
- Initial treatments were ineffective, highlighting diagnostic challenges.
Findings:
- The clinical history and presentation were consistent with PANS-PANDAS criteria.
- The patient's condition demonstrated a relapsing-remitting pattern, a known characteristic of the syndrome.
- Poor response to standard treatments indicated a potential underlying PANS-PANDAS etiology.
Implications:
- Emphasizes the need for increased medical community awareness regarding PANS-CANS.
- Highlights the importance of early identification to mitigate long-term morbidity.
- Suggests evaluating school-aged children with obsessive-compulsive or eating disorders for PANS-CANS.
Introduction:
Since 1980, there have been known cases of childhood neuropsychiatric syndromes in the world and its concept has evolved with changes in the definitions in 1995 (PITANDs - paediatric infection-triggered autoimmune neuropsychiatric disorders), 1998 (PANDAS - paediatric autoimmune neuropsychiatric syndrome associated with streptococci infection), 2010 (PANS - paediatric acute-onset neuropsychiatric syndrome) and 2012 (CANS - childhood acute neuropsychiatric syndrome). Despite being known for more than 20 years, it is still an illness that often goes unnoticed by many health professionals.
Objective:
To sensitise the medical community about the identification of the disease and reduce the morbidity associated with a late diagnosis.
Clinical Case:
A 6-year-old schoolgirl brought to the emergency department due to her refusal to eat. In the hospital treatment, a clinical history was identified with PANS-PANDAS diagnostic criteria. She exhibited a relapsing-remitting clinical course, as described in the literature, with poor response to first-line treatments.
Conclusions:
In all school-age child presenting with obsessive compulsive disorder or eating disorders, with other symptoms or not, a possible link to PANS-CANS should be evaluated and ruled out.
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