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PANS

Participants: Elisabeth Fernell, Mats Johnson, Iulian Preda & Christopher Gillberg.

Medical records study and study comprising medical examination of children affected by acute onset of neuropsychiatric symptoms; Pediatric Acute-onset Psychiatric Syndrome (PANS).

Background:The term PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) was first described by Susan Swedo and associates at the National Institute of Mental Health (NIMH) during the early 1990’s. Term PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) has later been introduced to focus more on the symptomatology. However, there is no complete scientific consensus on what the causes and features of this illness are, or how exactly it should be defined.

The diagnosis criteria for PANS is:
1) Abrupt, dramatic onset of obsessive-compulsive symptoms (often including very limited eating)
2) Other concurrent neuropsychiatric symptoms, with similar severe and acue onset, from at least two of the following seven categories: a) anxiety (especially separation anxiety), b) emotional instability (extreme mood swings) and/or depression, c) irritability, aggression and/or severe oppositional defiant behaviour, d) regression in behaviour/development, e) marked deterioration of schoolwork, f) sensory or motor problems, g) symptoms like sleeping disorder, nocturnal bedwetting or micturition urgency and
3) The symptoms cannot be explained better by another known neurological or medical condition.

The prevalence of PANS is not known, but clinically attention is today increasingly being directed toward this symptomatology and treatment efforts with antibiotics and immunoglobulin are carried out on a clinical basis.

There is a great need for systematic study of the group of children affected by acute onset neuropsychiatric symptoms, a fact clearly highlighted during the family week at Ågrenska in December 2015, after an initiative from the parents’/special interest association SANE.

Method: A study has been started by the GNC in order to potentially provide more knowledge on causes of PANS. The study includes a systematic review of medical records concerning children deemed consistent with PANS symptomatolgy and also offers the opportunity to participate in a study comprising blood tests. The medical study includes immunological analyses; cytokines and analysis of Human Leukocyte Antigen (HLA)-type, parenchymal damage markers (CNS) and genetic analysis; single nucleotide polymorphism (SNP-array). In conjunction with testing, a functional assessment is made according to criteria for PANS, along with scoring of the ABAS-II (Adaptive Behavior Assessment System) questionnaire. The questionnaire is based on the norm/standard for Swedish children and provides a good overview of the child's current level of function in terms of cognitive ability as well as social and practical skills.

Results: All immunological tests will be analysed at the same time and results will be presented on the GNC website.
 

Page Manager: Anna Spyrou|Last update: 9/19/2016
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