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Factors Associated with Symptom Persistence in PANS: Part I—Access to Care
Calaprice-Whitty D, Tang A, Tona J. Factors Associated with Symptom Persistence in PANS: Part I-Access to Care. J Child Adolesc Psychopharmacol. 2023 Nov;33(9):356-364. doi: 10.1089/cap.2023.0022. Epub 2023 Oct 30. PMID: 37902790.
  • Greater symptom persistence correlated with longer intervals between symptom onset and treatment (F = 4.43, p = 0.002).
  • Subjects with the least symptom persistence (>75% symptom-free days) were diagnosed by the first practitioner seen in 34% of cases, compared to 13% in those with the most persistent symptoms (symptoms every day) (L-R χ2 = 36.55, p < 0.0001).
  • Lack of access to expertise did not impede diagnosis and treatment for 52% of subjects with the least persistent symptoms, contrasting with 22% in those with the most persistent symptoms (L-R χ2 = 22.47, p < 0.0001).
  • Affordability did not impact diagnosis and treatment for 76% of subjects with the least persistent symptoms, whereas it affected 42% of those with the most persistent symptoms (L-R χ2 = 27.83, p < 0.0001).
  • Subjects whose PANS symptoms resolved with antibiotic treatment had less symptom persistence than others (χ2 = 23.27, p = 0.0001).
  • More persistently symptomatic subjects were more likely to discontinue intravenous immunoglobulin (IVIG) treatment due to access-to-care reasons.

“Conclusions: Unimpeded access to care for PANS is associated with more symptom-free days over reporting periods averaging approximately 4 years. Difficulty reaching expert providers, missed opportunities for diagnoses, and financial limitations may worsen outcomes. Practitioners, particularly primary providers, should adhere to published diagnostic and treatment guidelines promptly upon presentation.”

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Myth or Reality? The State of the Art on a Controversial Disease
La Bella S, Scorrano G, Rinaldi M, Di Ludovico A, Mainieri F, Attanasi M, Spalice A, Chiarelli F, Breda L. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Myth or Reality? The State of the Art on a Controversial Disease. Microorganisms. 2023 Oct 13;11(10):2549. doi: 10.3390/microorganisms11102549. PMID: 37894207; PMCID: PMC10609001.
Despite significant advances in the understanding of the pathogenesis and therapeutic management of affected children, PANDAS remains a subject of dispute among experts. The controversial issues discussed in this paper can primarily be attributed to the challenges associated with establishing a definitive and timely correlation between the occurrence or recurrence of OCD and tic disorder in children who experience multiple GAS infections. Furthermore, it is important to note that the existing research examining the effectiveness of treatment techniques suffers from limitations in terms of sample size and rigorous inclusion criteria, which consequently hinders the provision of robust recommendations. Additional research is required to enhance our comprehension of the real prevalence of the disease, the precise pathogenic pathways involved, and the appropriate evidence-based methodology for its treatment.
Everything changed at 4
Everything changed at 4

  We wish nothing but healing wishes for Stori. Stori’s mom shared her story with us on the day of PANS PANDAS Awareness Action Week, when we shared many stories....

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Not “just” ADHD

  Just like Holden, parents often hear about PANS/PANDAS through word of mouth or knowing a family with a kiddo already diagnosed. So, keep talking about PANS/PANDAS wherever you go....

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