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References

Dr Susan E. Swedo

[1] Swedo, S. E., Leonard, H. L., Garvey, M., Mittleman, B., Allen, A. J., Perlmutter, S., Lougee, L., Dow, S., Zamkoff, J., Dubbert, B. K. (1998).Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. American Journal of Psychiatry, 155(2), 264-71. Doi: 10.1176/ajp.155.2.264.

[2] Swedo, S. E. (2012). From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics, 2(2). doi: 10.4172/2161-0665.1000113

Current Medical Context

[3] Wilbur, C., Bitnun, A., Kronenberg, S., Laxer, R. M., Levy, D. M., Logan, W. J., Shouldice, M., & Yeh, E. A. (2018). PANDAS/PANS in childhood: Controversies and evidence. Paediatrics & Child Health, 24(2), 85–91. doi: 10.1093/pch/pxy145

‌[4] Xu, J., Liu, R.-J., Fahey, S., Frick, L., Leckman, J., Vaccarino, F., Duman, R. S., Williams, K., Swedo, S., & Pittenger, C. (2021). Antibodies From Children With PANDAS Bind Specifically to Striatal Cholinergic Interneurons and Alter Their Activity. American Journal of Psychiatry, 178(1), 48–64. doi: 10.1176/appi.ajp.2020.19070698

[5] Platt, M. P., Bolding, K. A., Wayne, C. R., Chaudhry, S., Cutforth, T., Franks, K. M., & Agalliu, D. (2020). Th17 lymphocytes drive vascular and neuronal deficits in a mouse model of postinfectious autoimmune encephalitis. Proceedings of the National Academy of Sciences, 117(12), 6708–6716.doi: 10.1073/pnas.1911097117

For Health Professionals

[1] Swedo, S.E., et al., Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry, 1998. 155(2): p. 264-71.

[2] Murphy, T.K., et al., Characterization of the pediatric acute-onset neuropsychiatric syndrome phenotype. J Child Adolesc Psychopharmacol, 2015. 25(1): p. 14-25.

[3] Orefici, G., et al., Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), in Streptococcus pyogenes: Basic Biology to Clinical Manifestations, J.J. Ferretti, D.L. Stevens, and V.A. Fischetti, Editors. 2016, The University of Oklahoma Health Sciences Center.: Oklahoma City (OK).

[4] Wilbur, C., et al., PANDAS/PANS in childhood: Controversies and evidence. Paediatr Child Health, 2019. 24(2): p. 85-91.

[5] Endres, D., et al., Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype? Translational Psychiatry, 2022. 12(1): p. 5.

[6] Chang, K., et al., Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference. Journal of child and adolescent psychopharmacology, 2015. 25(1): p. 3-13.

[7] Trifiletti, R., et al., Identification of ultra-rare genetic variants in pediatric acute onset neuropsychiatric syndrome (PANS) by exome and whole genome sequencing. Sci Rep, 2022. 12(1): p. 11106.

[8] Swedo, S.E., J.F. Leckman, and N.R. Rose, From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics, 2012. 2(2).

[9] Calaprice, D., et al., A Survey of Pediatric Acute-Onset Neuropsychiatric Syndrome Characteristics and Course. J Child Adolesc Psychopharmacol, 2017. 27(7): p. 607-618.

[10] Silverman, M., et al., Psychotic symptoms in youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) may reflect syndrome severity and heterogeneity. J Psychiatr Res, 2019. 110: p. 93-102.

[11] Pavone, P., et al., Severe Psychotic Symptoms in Youth with PANS/PANDAS: Case-Series. J Child Adolesc Psychopharmacol, 2020. 30(9): p. 567-571.

[12] Church, A.J., et al., Tourette’s syndrome: a cross sectional study to examine the PANDAS hypothesis. J Neurol Neurosurg Psychiatry, 2003. 74(5): p. 602-7.

[13] Swedo, S.E., H.L. Leonard, and J.L. Rapoport, The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. Pediatrics, 2004. 113(4): p. 907-11.

[14] Murphy, T.K., et al., Clinical factors associated with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Pediatr, 2012. 160(2): p. 314-9.

[15] Goncalves, M.V.M., et al., Pediatric acute-onset neuropsychiatric syndrome (PANS) misdiagnosed as autism spectrum disorder. Immunology Letters, 2018. 203: p. 52-53.

[16] Trifonova, E.A., et al., Abnormal mTOR Activity in Pediatric Autoimmune Neuropsychiatric and MIA-Associated Autism Spectrum Disorders. Int J Mol Sci, 2022. 23(2).

[17] Cellucci, T., et al., Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurology – Neuroimmunology Neuroinflammation, 2020. 7(2): p. e663.

[18] Gromark, C., et al., A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort. Child Psychiatry Hum Dev, 2022. 53(2): p. 354-364.

[19] Jaspers-Fayer, F., et al., Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol, 2017. 27(4): p. 332-341.

[20] Lorentzos, M.S., The Psychiatry of Paediatric Movement Disorders, in Discipline of Child and Adolescent Health. 2019, University of Sydney.

[21] Murphy, T.K., R. Kurlan, and J. Leckman, The immunobiology of Tourette’s disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders: a way forward. J Child Adolesc Psychopharmacol, 2010. 20(4): p. 317-31.

[22] Gromark, C., et al., Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet. J Child Adolesc Psychopharmacol, 2019. 29(8): p. 625-633.

[23] Hesselmark, E. and S. Bejerot, Patient Satisfaction and Treatments Offered to Swedish Patients with Suspected Pediatric Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. J Child Adolesc Psychopharmacol, 2019. 29(8): p. 634-641.

[24] De Visscher, C., et al., Measuring clinical outcomes in children with pediatric acute-onset neuropsychiatric syndrome: data from a 2–5 year follow-up study. BMC Psychiatry, 2021. 21(1): p. 484.

[25] Johnson, M., et al., Paediatric acute-onset neuropsychiatric syndrome in children and adolescents: an observational cohort study. Lancet Child Adolesc Health, 2019. 3(3): p. 175-180.

[26] Frankovich, J., et al., Multidisciplinary clinic dedicated to treating youth with pediatric acute-onset neuropsychiatric syndrome: presenting characteristics of the first 47 consecutive patients. J Child Adolesc Psychopharmacol, 2015. 25(1): p. 38-47.

[27] Brown, K.D., et al., Pediatric Acute-Onset Neuropsychiatric Syndrome Response to Oral Corticosteroid Bursts: An Observational Study of Patients in an Academic Community-Based PANS Clinic. Journal of child and adolescent psychopharmacology, 2017. 27(7): p. 629-639.

[28] Thienemann, M., et al., Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics. Journal of Psychiatric Research, 2021. 135: p. 270-278.

[29] Gamucci, A., et al., PANDAS and PANS: Clinical, Neuropsychological, and Biological Characterization of a Monocentric Series of Patients and Proposal for a Diagnostic Protocol. Journal of Child and Adolescent Psychopharmacology, 2019. 29(4): p. 305-312.

[30] Lepri, G., et al., Clinical-Serological Characterization and Treatment Outcome of a Large Cohort of Italian Children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute Neuropsychiatric Syndrome. J Child Adolesc Psychopharmacol, 2019. 29(8): p. 608-614.

[31] Pavone, P., et al., Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS): Clinical Manifestations, IVIG Treatment Outcomes, Results from a Cohort of Italian Patients. Neuropsychiatry, 2018. 08.

[32] Rea, I., C.A. Guido, and A. Spalice, Clinical Features in Patients With PANDAS/PANS and Therapeutic Approaches: A Retrospective Study. Front Neurol, 2021. 12: p. 741176.

[33] Prato, A., et al., Diagnostic Approach to Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS): A Narrative Review of Literature Data. Front Pediatr, 2021. 9: p. 746639.

[34] Thienemann, M., et al., Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I-Psychiatric and Behavioral Interventions. J Child Adolesc Psychopharmacol, 2017. 27(7): p. 566-573.

[35] Frankovich, J., et al., Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies. Journal of Child and Adolescent Psychopharmacology, 2017. 27(7): p. 574-593.

[36] Cooperstock, M.S., et al., Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Prevention of Infections. Journal of Child and Adolescent Psychopharmacology, 2017. 27(7): p. 594-606.

[37] Swedo, S.E., J. Frankovich, and T.K. Murphy, Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of child and adolescent psychopharmacology, 2017. 27(7): p. 562-565.

[38] Swedo, S.E., Memo from the Department of Health and Human Services Regarding IVIG for AE PANS PANDAS. . 2017: PANDAS Physicians Network.

[39] Pfeiffer, H.C.V., et al., Clinical guidance for diagnosis and management of suspected Pediatric Acute-onset Neuropsychiatric Syndrome in the Nordic countries. Acta Paediatr, 2021. 110(12): p. 3153-3160.

[40] Murphy, T., E. Storch, and M. Strawser, Selective serotonin reuptake inhibitor-induced behavioral activation in the PANDAS subtype. Primary Psychiatry, 2006. 13.

[41] Sigra, S., E. Hesselmark, and S. Bejerot, Treatment of PANDAS and PANS: a systematic review. Neurosci Biobehav Rev, 2018. 86: p. 51-65.

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Glossary

  • ADHD
    Attention Deficit Hyperactivity Disorder
  • AE
    Auto-immune Encephalitis
  • ARFID
    Avoidant Restrictive Food Intake Disorder
  • ASD
    Autism Spectrum Disorder
  • CAMHS
    Child and Adolescent Mental Health Service
  • CBT
    Cognitive Behavioural Therapy
  • Dysgraphia
    difficulty writing by hand
  • EHCP
    Education, Health and Care Plan
  • Emotional Lability
    Rapid, and dramatic changes in mood (for example uncontrollable laughter to crying)
  • Enuresis
    wetting
  • GAS
    Group A Streptococcal infection
  • NHSE
    NHS England
  • NICE
    National Institute for Health and Care Excellence
  • OCD
    Obsessive Compulsive Disorder
  • PP
    PANS PANDAS
  • PPUK
    PANS PANDAS UK
  • PPN
    PANS Physicians Network
  • PPSG
    PANS PANDAS Steering Group
  • SENCo
    Special Educational Needs Coordinator
  • SIGN
    Scottish Intercollegiate Guidelines Network to the glossary
  • Tic
    Sudden repetitive movement (motor tic) or sound (vocal tic) which is difficult or impossible to control