Authors' reply regarding “On diagnosing and treating PANS/PANDAS: Questions from a patient support group”

Pfeiffer, Helle Cecilie Viekilde; Visscher, Caroline De; Gjone, Inger Helene; Ygberg, Sofia; Herner, Linn Breen; Hesselmark, Eva; Nordström, Sam; Sandvig, Inger; Skov, Lone; Sørensen, Camilla Birgitte; Lim, Ming; Wickström, Ronny; Hedderly, Tammy; Debes, Nanette Mol

doi:10.1111/apa.16149

Cited by 2 publications

(3 citation statements)

References 5 publications

(7 reference statements)

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“…In addition, LP is considered a necessary diagnostic investigation in PANS when a differential diagnosis with other immunological or metabolic CNS diseases is needed (AE, CNS vasculitis, neuropsychiatric SLE [NPSLE], Acute Disseminated Encephalomyelitis and infectious encephalitis). 7 , 33 , 121 , 122 Although with a limited sensitivity, 47 CSF evaluation should include chemical tests (glucose and protein), cell counts, assays for antineuronal antibodies (eg, anti-NMDA receptor antibodies) and oligoclonal bands.…”

Section: Results and Considerations Of Laboratory Testsmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives

Gagliano¹,

Carta²,

Tanca³

et al. 2023

NDT

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Pediatric acute-onset neuropsychiatric syndrome (PANS) features a heterogeneous constellation of acute obsessive-compulsive disorder (OCD), eating restriction, cognitive, behavioral and/or affective symptoms, often followed by a chronic course with cognitive deterioration. An immune-mediated etiology is advocated in which the CNS is hit by different pathogen-driven (auto)immune responses. This narrative review focused on recent clinical (ie, diagnostic criteria, pre-existing neurodevelopmental disorders, neuroimaging) and pathophysiological (ie, CSF, serum, genetic and autoimmune findings) aspects of PANS. We also summarized recent points to facilitate practitioners with the disease management. Relevant literature was obtained from PubMed database which included only English-written, full-text clinical studies, case reports, and reviews. Among a total of 1005 articles, 205 were pertinent to study inclusion. Expert opinions are converging on PANS as the effect of post-infectious events or stressors leading to “brain inflammation”, as it is well-established for anti-neuronal psychosis. Interestingly, differentiating PANS from either autoimmune encephalitides and Sydenham’s chorea or from alleged “pure” psychiatric disorders (OCD, tics, Tourette’s syndrome), reveals several overlaps and more analogies than differences. Our review highlights the need for a comprehensive algorithm to help both patients during their acute distressing phase and physicians during their treatment decision. A full agreement on the hierarchy of each therapeutical intervention is missing owing to the limited number of randomized controlled trials. The current approach to PANS treatment emphasizes immunomodulation/anti-inflammatory treatments in association with both psychotropic and cognitive-behavioral therapies, while antibiotics are suggested when an active bacterial infection is established. A dimensional view, taking into account the multifactorial origin of psychiatric disorders, should suggest neuro-inflammation as a possible shared substrate of different psychiatric phenotypes. Hence, PANS and PANS-related disorders should be considered as a conceptual framework describing the etiological and phenotypical complexity of many psychiatric disorders.

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Section: Results and Considerations Of Laboratory Testsmentioning

confidence: 99%

“…As stated before, psychotropic medications (such as and selective serotonin uptake inhibitors), in association with cognitive behavioral therapy, is considered the first treatment step in North-European countries. 121 , 122 , 149 …”

Section: Treatmentmentioning

confidence: 99%

Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives

Gagliano¹,

Carta²,

Tanca³

et al. 2023

NDT

View full text Add to dashboard Cite

show abstract

“…These recommendations were prepared by a working group that comprised a paediatric neurologist, child psychiatrists and psychologists from Denmark, Norway, Sweden and the UK. Members of a patient organisation have commented on the guidelines, 5 and the working group has responded 6 …”

Section: How To Diagnose and Manage Suspected Paediatric Acute‐onset ...mentioning

confidence: 99%

Issue highlights December 2021

Käll¹,

Lagercrantz²

2021

Acta Paediatrica

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Authors' reply regarding “On diagnosing and treating PANS/PANDAS: Questions from a patient support group”

Cited by 2 publications

References 5 publications

Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives

Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives

Issue highlights December 2021

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