Paediatric acute-onset neuropsychiatric syndrome

Pfeiffer HCV, Wickstrom R, Skov L, et al. Clinical guidance for diagnosis and management of suspected pediatric acute-onset neuropsychiatric syndrome in the Nordic countries. Acta Paediatr. 2021 Dec;110(12):3153-60.Full text  Abstract

Chang K, Frankovich J, Cooperstock M, et al. Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):3-13.Full text  Abstract

Cooperstock MS, Swedo SE, Pasternack MS, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part III-treatment and prevention of infections. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):594-606.Full text  Abstract

Frankovich J, Swedo S, Murphy T, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part II-use of immunomodulatory therapies. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):574-93.Full text  Abstract

Thienemann M, Murphy T, Leckman J, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part I-psychiatric and behavioral interventions. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):566-73.Full text  Abstract

1. Swedo SE, Leckman JF, Rose NR. From research subgroup to clinical syndrome: modifying the PANDAS criteria to describe PANS (pediatric acute-onset neuropsychiatric syndrome). Pediatr Ther. 2012;2(2):1000113.Full text

2. Pfeiffer HCV, Wickstrom R, Skov L, et al. Clinical guidance for diagnosis and management of suspected pediatric acute-onset neuropsychiatric syndrome in the Nordic countries. Acta Paediatr. 2021 Dec;110(12):3153-60.Full text  Abstract

3. Frankovich J, Thienemann M, Pearlstein 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 Feb;25(1):38-47. Abstract

4. Gromark C, Harris RA, Wickström R, 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 Oct;29(8):625-33.Full text  Abstract

5. Gromark C, Hesselmark E, Djupedal IG, et al. A two-to-five year follow-up of a pediatric acute-onset neuropsychiatric syndrome cohort. Child Psychiatry Hum Dev. 2022 Apr;53(2):354-64.Full text  Abstract

6. Swedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998 Feb;155(2):264-71.Full text  Abstract

7. Murphy TK, Patel PD, McGuire JF, et al. Characterization of the pediatric acute-onset neuropsychiatric syndrome phenotype. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):14-25. Abstract

8. Swedo SE, Seidlitz J, Kovacevic M, et al. Clinical presentation of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections in research and community settings. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):26-30.Full text  Abstract

9. Johnson M, Fernell E, Preda I, et al. Paediatric acute-onset neuropsychiatric syndrome in children and adolescents: an observational cohort study. Lancet Child Adolesc Health. 2019 Mar;3(3):175-80. Abstract

10. Frankovich J, Leibold CM, Farmer C, et al. The burden of caring for a child or adolescent with pediatric acute-onset neuropsychiatric syndrome (PANS): an observational longitudinal study. J Clin Psychiatry. 2018 Dec 11;80(1):17m12091. Abstract

11. Farmer C, Thienemann M, Leibold C, et al. Psychometric evaluation of the caregiver burden inventory in children and adolescents with PANS. J Pediatr Psychol. 2018 Aug 1;43(7):749-57.Full text  Abstract

12. World Health Organization. International statistical classification of diseases and related health problems. 11th revision. Jan 2022 [internet publication].Full text

13. Wald E, Eickhoff J, Flood GE. Estimate of the incidence of PANDAS and PANS in 3 primary care populations. Front Pediatr. 2023 Sep 21;11:1170379.Full text

14. Flament MF, Whitaker A, Rapoport JL, et al. Obsessive compulsive disorder in adolescence: an epidemiological study. J Am Acad Child Adolesc Psychiatry. 1988 Nov;27(6):764-71. Abstract

15. Valleni-Basile LA, Garrison CZ, Jackson KL, et al. Frequency of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry. 1994 Jul-Aug;33(6):782-91. Abstract

16. Jaspers-Fayer F, Han SHJ, Chan E, et al. Prevalence of acute-onset subtypes in pediatric obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2017 May;27(4):332-41. Abstract

17. Aman M, Coelho JS, Lin B, et al. Prevalence of pediatric acute-onset neuropsychiatric syndrome (PANS) in children and adolescents with eating disorders. J Eat Disord. 2022 Dec 13;10(1):194.Full text  Abstract

18. Singer HS, Giuliano JD, Zimmerman AM, et al. Infection: a stimulus for tic disorders. Pediatr Neurol. 2000 May;22(5):380-3. Abstract

19. Garvey MA, Giedd J, Swedo SE. PANDAS: the search for environmental triggers of pediatric neuropsychiatric disorders. Lessons from rheumatic fever. J Child Neurol. 1998 Sep;13(9):413-23. Abstract

20. Chang K, Frankovich J, Cooperstock M, et al. Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):3-13.Full text  Abstract

21. Lepri G, Rigante D, Bellando Randone S, 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 Oct;29(8):608-14. Abstract

22. Cunningham MW. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev. 2000 Jul;13(3):470-511.Full text  Abstract

23. Brown KD, Farmer C, Freeman GM Jr, et al. Effect of early and prophylactic nonsteroidal anti-inflammatory drugs on flare duration in pediatric acute-onset neuropsychiatric syndrome: an observational study of patients followed by an academic community-based pediatric acute-onset neuropsychiatric syndrome clinic. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):619-28. Abstract

24. Spartz EJ, Freeman GM Jr, Brown K, et al. Course of neuropsychiatric symptoms after introduction and removal of nonsteroidal anti-inflammatory drugs: a pediatric observational study. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):652-9. Abstract

25. Brown K, Farmer C, Farhadian B, et al. Pediatric acute-onset neuropsychiatric syndrome response to oral corticosteroid bursts: an observational study of patients in an academic community-based PANS clinic. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):629-39. Abstract

26. Perlmutter SJ, Leitman SF, Garvey MA, et al. Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood. Lancet. 1999 Oct 2;354(9185):1153-8. Abstract

27. Latimer ME, L'Etoile N, Seidlitz J, et al. Therapeutic plasma apheresis as a treatment for 35 severely ill children and adolescents with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):70-5. Abstract

28. Melamed I, Kobayashi RH, O'Connor M, et al. Evaluation of intravenous immunoglobulin in pediatric acute-onset neuropsychiatric syndrome. J Child Adolesc Psychopharmacol. 2021 Mar;31(2):118-28.Full text  Abstract

29. Kovacevic M, Grant P, Swedo SE. Use of intravenous immunoglobulin in the treatment of twelve youths with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):65-9.Full text  Abstract

30. Mell LK, Davis RL, Owens D. Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder. Pediatrics. 2005 Jul;116(1):56-60. Abstract

31. Leslie DL, Kozma L, Martin A, et al. Neuropsychiatric disorders associated with streptococcal infection: a case-control study among privately insured children. J Am Acad Child Adolesc Psychiatry. 2008 Oct;47(10):1166-72.Full text  Abstract

32. Orlovska S, Vestergaard CH, Bech BH, et al. Association of streptococcal throat infection with mental disorders: testing key aspects of the PANDAS hypothesis in a nationwide study. JAMA Psychiatry. 2017 Jul 1;74(7):740-6.Full text  Abstract

33. Cooperstock MS, Swedo SE, Pasternack MS, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part III-treatment and prevention of infections. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):594-606.Full text  Abstract

34. Murphy TK, Snider LA, Mutch PJ, et al. Relationship of movements and behaviors to group A streptococcus infections in elementary school children. Biol Psychiatry. 2007 Feb 1;61(3):279-84.Full text  Abstract

35. Chan A, Frankovich J. Infections, antibiotics, and mental health deteriorations. J Child Adolesc Psychopharmacol. 2019 Oct;29(8):647-8. Abstract

36. Cutforth T, DeMille MM, Agalliu I, et al. CNS autoimmune disease after Streptococcus pyogenes infections: animal models, cellular mechanisms and genetic factors. Future Neurol. 2016 Dec;11(1):63-76.Full text  Abstract

37. Zheng J, Frankovich J, McKenna ES, et al. Association of pediatric acute-onset neuropsychiatric syndrome with microstructural differences in brain regions detected via diffusion-weighted magnetic resonance imaging. JAMA Netw Open. 2020 May 1;3(5):e204063.Full text  Abstract

38. Cabrera B, Romero-Rebollar C, Jiménez-Ángeles L, et al. Neuroanatomical features and its usefulness in classification of patients with PANDAS. CNS Spectr. 2019 Oct;24(5):533-43. Abstract

39. Kumar A, Williams MT, Chugani HT. Evaluation of basal ganglia and thalamic inflammation in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection and tourette syndrome: a positron emission tomographic (PET) study using 11C-[R]-PK11195. J Child Neurol. 2015 May;30(6):749-56. Abstract

40. Giedd JN, Rapoport JL, Garvey MA, et al. MRI assessment of children with obsessive-compulsive disorder or tics associated with streptococcal infection. Am J Psychiatry. 2000 Feb;157(2):281-3.Full text  Abstract

41. Rahman S, Gaertner F, Houghton J, et al. Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by a novel subset of monocytes with markers associated with crossing the blood brain barrier (BBB) [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 4).Full text

42. Frick LR, Rapanelli M, Jindachomthong K, et al. Differential binding of antibodies in PANDAS patients to cholinergic interneurons in the striatum. Brain Behav Immun. 2018 Mar;69:304-11.Full text  Abstract

43. Xu J, Liu RJ, Fahey S, et al. Antibodies from children with PANDAS bind specifically to striatal cholinergic interneurons and alter their activity. Am J Psychiatry. 2021 Jan 1;178(1):48-64.Full text  Abstract

44. Chain JL, Alvarez K, Mascaro-Blanco A, et al. Autoantibody biomarkers for basal ganglia encephalitis in Sydenham chorea and pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections. Front Psychiatry. 2020 Jun 24:11:564.Full text  Abstract

45. Hoffman KL, Hornig M, Yaddanapudi K, et al. A murine model for neuropsychiatric disorders associated with group A beta-hemolytic streptococcal infection. J Neurosci. 2004 Feb 18;24(7):1780-91.Full text  Abstract

46. Brimberg L, Benhar I, Mascaro-Blanco A, et al. Behavioral, pharmacological, and immunological abnormalities after streptococcal exposure: a novel rat model of Sydenham chorea and related neuropsychiatric disorders. Neuropsychopharmacology. 2012 Aug;37(9):2076-87.Full text  Abstract

47. Dileepan T, Smith ED, Knowland D, et al. Group A Streptococcus intranasal infection promotes CNS infiltration by streptococcal-specific Th17 cells. J Clin Invest. 2016 Jan;126(1):303-17.Full text  Abstract

48. Gagliano A, Galati C, Ingrassia M, et al. Pediatric acute-onset neuropsychiatric syndrome: a data mining approach to a very specific constellation of clinical variables. J Child Adolesc Psychopharmacol. 2020 Oct;30(8):495-511. Abstract

49. Chan A, Phu T, Farhadian B, et al. Familial clustering of immune-mediated diseases in children with abrupt-onset obsessive compulsive disorder. J Child Adolesc Psychopharmacol. 2020 Jun;30(5):345-6. Abstract

50. Calaprice D, Tona J, Parker-Athill EC, et al. A survey of pediatric acute-onset neuropsychiatric syndrome characteristics and course. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):607-18.Full text  Abstract

51. Frankovich J, Swedo S, Murphy T, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part II-use of immunomodulatory therapies. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):574-93.Full text  Abstract

52. Swedo SE, Leonard HL, Mittleman BB, et al. Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever. Am J Psychiatry. 1997 Jan;154(1):110-2. Abstract

53. Ma M, Sandberg J, Farhadian B, et al. Arthritis in children with psychiatric deteriorations: a case series. Dev Neurosci. 2023 May 12 [Epub ahead of print].Full text  Abstract

54. Swedo SE, Leonard HL, Rapoport JL. The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. Pediatrics. 2004 Apr;113(4):907-11. Abstract

55. Murphy TK, Storch EA, Lewin AB, et al. Clinical factors associated with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Pediatr. 2012 Feb;160(2):314-9.Full text  Abstract

56. Bernstein GA, Victor AM, Pipal AJ, et al. Comparison of clinical characteristics of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and childhood obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2010 Aug;20(4):333-40. Abstract

57. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.Full text

58. Frankovich J, Thienemann M, Rana S, et al. Five youth with pediatric acute-onset neuropsychiatric syndrome of differing etiologies. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):31-7.Full text  Abstract

59. Silverman M, Frankovich J, Nguyen E, et al. Psychotic symptoms in youth with pediatric acute-onset neuropsychiatric syndrome (PANS) may reflect syndrome severity and heterogeneity. J Psychiatr Res. 2019 Mar;110:93-102. Abstract

60. Johnson M, Ehlers S, Fernell E, et al. Anti-inflammatory, antibacterial and immunomodulatory treatment in children with symptoms corresponding to the research condition PANS (Pediatric Acute-onset Neuropsychiatric Syndrome): a systematic review. PLoS One. 2021 Jul 1;16(7):e0253844.Full text  Abstract

61. Scahill L, Riddle MA, McSwiggin-Hardin M, et al. Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry. 1997 Jun;36(6):844-52.Full text  Abstract

62. Mahony T, Sidell D, Gans H, et al. Palatal petechiae in the absence of group A streptococcus in pediatric patients with acute-onset neuropsychiatric deterioration: a cohort study. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):660-6. Abstract

63. Toufexis MD, Hommer R, Gerardi DM, et al. Disordered eating and food restrictions in children with PANDAS/PANS. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):48-56.Full text  Abstract

64. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102.Full text  Abstract

65. American Academy of Pediatrics. Group A streptococcal infections. In: Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red book: 2021-2024 report of the Committee on Infectious Diseases, 32nd ed. Itasca, IL: American Academy of Pediatrics; 2021.Full text

66. Eichbaum QG, Hughes EJ, Epstein JE, et al. Rheumatic fever: autoantibodies against a variety of cardiac, nuclear, and streptococcal antigens. Ann Rheum Dis. 1995 Sep;54(9):740-3.Full text  Abstract

67. Cellucci T, Van Mater H, Graus F, et al. Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 17;7(2):e663.Full text  Abstract

68. Santoro JD, Frankovich J, Bhargava S. Continued presence of period limb movements during REM sleep in patients with chronic static pediatric acute-onset neuropsychiatric syndrome (PANS). J Clin Sleep Med. 2018 Jul 15;14(7):1187-92.Full text  Abstract

69. Gaughan T, Buckley A, Hommer R, et al. Rapid eye movement sleep abnormalities in children with pediatric acute-onset neuropsychiatric syndrome (PANS). J Clin Sleep Med. 2016 Jul 15;12(7):1027-32.Full text  Abstract

70. Swedo SE. Sydenham's chorea. A model for childhood autoimmune neuropsychiatric disorders. JAMA. 1994 Dec 14;272(22):1788-91. Abstract

71. Chan A, Karpel H, Spartz E, et al. Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome. Pediatr Res. 2021 May;89(6):1477-84.Full text  Abstract

72. Katzman DK, Norris ML, Zucker N. Avoidant restrictive food intake disorder. Psychiatr Clin North Am. 2019 Mar;42(1):45-57. Abstract

73. Openneer TJC, Huyser C, Martino D, et al. Clinical precursors of tics: an EMTICS study. J Child Psychol Psychiatry. 2022 Mar;63(3):305-14.Full text  Abstract

74. Groth C, Mol Debes N, Rask CU, et al. Course of Tourette syndrome and comorbidities in a large prospective clinical study. J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):304-12. Abstract

75. Gill CE, Kompoliti K. Clinical features of Tourette syndrome. J Child Neurol. 2020 Feb;35(2):166-74. Abstract

76. Lewinsohn PM, Klein DN, Seeley JR. Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):454-63. Abstract

77. Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007 May;64(5):543-52.Full text  Abstract

78. Amerio A, Stubbs B, Odone A, et al. The prevalence and predictors of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review and meta-analysis. J Affect Disord. 2015 Nov 1;186:99-109. Abstract

79. Joshi G, Wozniak J, Petty C, et al. Clinical characteristics of comorbid obsessive-compulsive disorder and bipolar disorder in children and adolescents. Bipolar Disord. 2010 Mar;12(2):185-95.Full text  Abstract

80. Mahmud FH, Lteif AN, Renaud DL, et al. Steroid-responsive encephalopathy associated with Hashimoto's thyroiditis in an adolescent with chronic hallucinations and depression: case report and review. Pediatrics. 2003 Sep;112(3 pt 1):686-90. Abstract

81. Benseler SM, Silverman ED. Neuropsychiatric involvement in pediatric systemic lupus erythematosus. Lupus. 2007;16(8):564-71. Abstract

82. Slattery MJ, Dubbert BK, Allen AJ, et al. Prevalence of obsessive-compulsive disorder in patients with systemic lupus erythematosus. J Clin Psychiatry. 2004 Mar;65(3):301-6. Abstract

83. Fox PC. Autoimmune diseases and Sjogren's syndrome: an autoimmune exocrinopathy. Ann N Y Acad Sci. 2007 Mar;1098:15-21. Abstract

84. Nickels K, Wirrell E. Electrical status epilepticus in sleep. Semin Pediatr Neurol. 2008 Jun;15(2):50-60. Abstract

85. Swedo SE, Frankovich J, Murphy TK. Overview of treatment of pediatric acute-onset neuropsychiatric syndrome. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):562-5.Full text  Abstract

86. Thienemann M, Murphy T, Leckman J, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part I-psychiatric and behavioral interventions. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):566-73.Full text  Abstract

87. Thienemann M, Park M, Chan A, et al. Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics. J Psychiatr Res. 2021 Mar;135:270-8. Abstract

88. Williams KA, Swedo SE, Farmer CA, et al. Randomized, controlled trial of intravenous immunoglobulin for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Am Acad Child Adolesc Psychiatry. 2016 Oct;55(10):860-7.e2. Abstract

89. ClinicalTrials.gov. Phase III study to compare the effect of panzyga versus placebo in patients with pediatric acute-onset neuropsychiatric syndrome. NCT04508530. Oct 2023 [internet publication].Full text

90. Ellerkamp H, Thienemann M, Tinero J, et al. Group psychotherapy for parents of youth with pediatric acute-onset neuropsychiatric syndrome. J Clin Psychol Med Settings. 2023 Sep;30(3):660-72. Abstract