No abstract

The food refusal associated with PANS is compared with symptoms listed for the new Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-V) diagnosis of avoidant/restrictive food intake disorder (ARFID). Treatment implications are discussed, as well as directions for further research.

Acute-onset OCD and/or tics in children, known by the term Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS), has been a focus of pediatric developmental and psychiatric research for nearly three decades. Studies have suggested that this condition results from molecular mimicry, in which anti-basal ganglia antibodies target brain proteins. While the pathogenesis of this condition is still widely debated, the clinical phenotype has shown consistent features and evidence that the dramatic symptoms cause substantial impairment in the child and in family functioning.

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This case illustrates the importance of differential diagnosis between toxidromes and how clinical presentation can be altered by preexisting conditions as well as the use of medications that affect multiple neurotransmitter systems.