Estimate of the Incidence of PANDAS and PANS in 3 Primary Care Populations

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2023 Oct 9

PMID 37808558

Authors

Ellen R Wald

Jens Eickhoff

Grace E Flood

Michael V Heinz

Daniel Liu

Alisha Agrawal

Richard P Morse

Veronica M Raney

Aravindhan Veerapandiyan

Juliette C Madan

Affiliations

Soon will be listed here.

Abstract

Objective: Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS) and Pediatric Acute-Onset Neuropsychiatric syndrome (PANS) are presumed autoimmune complications of infection or other instigating events. To determine the incidence of these disorders, we performed a retrospective review for the years 2017-2019 at three academic medical centers.

Methods: We identified the population of children receiving well-child care at each institution. Potential cases of PANS and PANDAS were identified by including children age 3-12 years at the time they received one of five new diagnoses: avoidant/restrictive food intake disorder, other specified eating disorder, separation anxiety disorder of childhood, obsessive-compulsive disorder, or other specified disorders involving an immune mechanism, not elsewhere classified. Tic disorders was not used as a diagnostic code to identify cases. Data were abstracted; cases were classified as PANDAS or PANS if standard definitions were met.

Results: The combined study population consisted of 95,498 individuals. The majority were non-Hispanic Caucasian (85%), 48% were female and the mean age was 7.1 (SD 3.1) years. Of 357 potential cases, there were 13 actual cases [mean age was 6.0 (SD 1.8) years, 46% female and 100% non-Hispanic Caucasian]. The estimated annual incidence of PANDAS/PANS was 1/11,765 for children between 3 and 12 years with some variation between different geographic areas.

Conclusion: Our results indicate that PANDAS/PANS is a rare disorder with substantial heterogeneity across geography and time. A prospective investigation of the same question is warranted.

Citing Articles

Psychometric Properties of the PANS 31-Item Symptom Rating Scale.

Bernstein G, Khan M, Freese R, Manko C, Silverman M, Ahmed S J Child Adolesc Psychopharmacol. 2024; 34(3):157-162.

PMID: 38536004 PMC: 11040192. DOI: 10.1089/cap.2023.0088.

Immunological characterization of an Italian PANDAS cohort.

Leonardi L, Lorenzetti G, Carsetti R, Piano Mortari E, Guido C, Zicari A Front Pediatr. 2024; 11:1216282.

PMID: 38239595 PMC: 10794562. DOI: 10.3389/fped.2023.1216282.

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