Ella Walter
PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other distressing symptoms. There is no single blood test or scan to detect PANS or PANDAS, and diagnosis requires expert clinical knowledge. Testing may support a diagnosis, but it is not required. A careful medical history, physical examination, and laboratory findings are key to diagnosis. The Cunningham Panel, a set of five individual tests that assess autoimmune antibody levels, can be used to indicate PANDAS-like antibody levels. If you suspect your child may have PANS or PANDAS, contact your child's doctor right away and consider therapy.
| Characteristics | Values |
|---|---|
| Diagnosis | Clinical diagnosis, no single blood test |
| Symptoms | OCD, tics, eating disorder, anxiety, aggression, behavioural or learning regression, sensory abnormalities, night terrors, bedwetting, anger, depression |
| Tests | Blood tests, Cunningham Panel, IgG, IgM, IgA, IgE, ANA, CBC, ferritin, B12, vitamin D, viral and bacterial testing, medical history |
| Treatment | Antidepressants, CBT, immunology treatment |
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What You'll Learn
There is no single test for PANS or PANDAS
There is currently no single test to detect PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococci). Instead, a combination of tests is necessary to rule out other disorders and establish a correct diagnosis and treatment plan.
PANS and PANDAS are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other confusing and distressing symptoms. These can include restricted eating, anger, depression, aggression, behavioural or learning regression, sensory abnormalities, and somatic symptoms such as night terrors or bedwetting.
The symptoms of PANS and PANDAS may also be present in other mental health disorders, making it challenging to pinpoint the exact cause. Therefore, a combination of clinical evaluations, laboratory tests, and a detailed review of the patient's medical history are required. Blood tests can serve as a helpful diagnostic tool, as biological markers provide additional evidence to physicians looking to confirm a diagnosis. Doctors may conduct blood work and other in-office tests to assess a patient's condition. A total basic blood workup may include IgE, IgA, IgM and IgG antibodies, antinuclear antibodies (ANA), a complete blood count (CBC), ferritin (iron), B12 and vitamin D. In addition to basic blood work, viral and bacterial testing for strep throat is required, as Group A Streptococcus bacteria can sometimes cause strep throat, which may be linked to PANDAS in children.
The Cunningham Panel is another test that can be used. It consists of five individual tests that assess autoimmune antibody levels. These tests are for the dopamine D1 receptor, dopamine D2L receptor, lysoganglioside GM1, tubulin and CaM kinase II. Elevated levels on one or more of these tests indicate that a patient’s neuropsychiatric symptoms may be due to a treatable autoimmune disorder that was possibly triggered by an infection.
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A combination of tests is required to rule out other disorders
PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder) are severe forms of OCD that appear suddenly in young children, accompanied by other confusing and distressing symptoms. These symptoms include the sudden onset of food restrictions, extreme anxiety, aggression, behavioural or learning regression, sensory abnormalities, and somatic symptoms such as night terrors or bedwetting.
There is no single blood test that can detect PANS or PANDAS. However, a combination of tests is required to rule out other disorders and establish a correct diagnosis and treatment plan. A thorough medical history, physical examination, and blood tests are necessary to determine whether an immune response, a sign of infections, is causing the symptoms. Doctors may conduct blood work and other in-office tests to assess the patient's condition. A basic blood workup may include IgE, IgA, IgM, and IgG antibodies, antinuclear antibodies (ANA), a complete blood count (CBC), ferritin (iron), B12, and vitamin D. In addition to basic blood work, viral and bacterial testing for strep throat is essential, as Group A Streptococcus bacteria can cause strep throat, which may be linked to PANDAS in children. Testing all family members is important to ensure no one is an asymptomatic strep carrier.
The Cunningham Panel, consisting of five individual tests that assess autoimmune antibody levels, is another valuable tool. Elevated levels in one or more of these tests indicate that a child's neuropsychiatric symptoms may be due to a treatable autoimmune disorder triggered by an infection. This can guide healthcare professionals in diagnosing and treating PANS or PANDAS.
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Lab tests can help physicians diagnose PANS/PANDAS
PANS (Paediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococci) are severe forms of OCD that appear suddenly in young children, accompanied by other confusing and distressing symptoms. The symptoms of PANS and PANDAS may also be present in other mental health disorders, making it challenging to pinpoint the exact cause. This is why a combination of tests is necessary to rule out other disorders and establish the correct diagnosis and treatment plan.
There is currently no single blood test that can detect PANS or PANDAS. However, lab tests can guide healthcare professionals in diagnosing and treating the condition. Doctors may conduct blood work and other in-office tests to assess a patient's condition. A basic blood workup may include IgE, IgA, IgM, and IgG antibodies, antinuclear antibodies (ANA), a complete blood count (CBC), ferritin (iron), B12, and vitamin D. In addition to basic blood work, viral and bacterial testing for strep throat is also necessary.
The Cunningham Panel, consisting of five individual tests that assess autoimmune antibody levels, is another laboratory test that can be used. These tests are for the dopamine D1 receptor, dopamine D2L receptor, lysoganglioside GM1, tubulin, and CaM kinase II. Elevated levels on one or more of these tests indicate that a child's neuropsychiatric symptoms may be due to a treatable autoimmune disorder possibly triggered by an infection.
Lab results can provide explanations for some of the symptoms a patient is experiencing. For example, patients with high anti-dopamine D1 antibodies often report having psychiatric symptoms such as OCD behaviours and tics. Those with elevated anti-dopamine D2L antibodies report symptoms such as hyperactivity, impulsivity, and other uncontrolled motor movements. Patients with elevated anti-lysoganglioside-GM1 antibodies often report obsessions/compulsions, sleep disturbances, and aggression. Those with elevated anti-tubulin levels experience brain fog, OCD-like symptoms, and cognitive impairment. Patients with elevated CaM kinase II levels report having involuntary movements, cognitive interference, emotional lability, and other neuropsychiatric symptoms.
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Blood tests can be used to diagnose PANS/PANDAS
Blood tests can be used to diagnose PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococci). PANS and PANDAS are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other confusing and distressing symptoms.
Blood work can serve as a helpful diagnostic tool for PANDAS/PANS. Doctors may conduct blood work and other in-office tests to assess a patient's condition. A total basic blood workup may include IgE, IgA, IgM, and IgG antibodies, antinuclear antibodies (ANA), a complete blood count (CBC), ferritin (iron), B12, and vitamin D. In addition to basic blood work, viral and bacterial testing for strep throat is also necessary. This is because Group A Streptococcus bacteria can sometimes cause strep throat, which may be linked to PANDAS in children.
The Cunningham Panel, consisting of five individual tests that assess autoimmune antibody levels, is another blood test used to diagnose PANDAS. These tests are for the dopamine D1 receptor, dopamine D2L receptor, lysoganglioside GM1, tubulin, and CaM kinase II. Elevated levels on one or more of these tests indicate that a patient’s neuropsychiatric symptoms may be due to a treatable autoimmune disorder possibly triggered by an infection.
It is important to note that there is no single blood test that can detect PANDAS or PANS. Blood tests are used in conjunction with other tests and evaluations to diagnose these conditions. A careful history and a hands-on physical examination by a physician well-versed in PANS and PANDAS are crucial to ensure that the symptoms are not the result of other serious medical conditions.
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A physical examination is required to rule out other serious medical conditions
PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder) are severe forms of OCD that appear suddenly in young children, accompanied by other confusing and distressing symptoms. PANDAS is diagnosed when the same symptoms as PANS are observed following a suspected strep infection.
There is currently no single blood test or biological marker that can detect PANS or PANDAS. However, a physical examination is required to rule out other serious medical conditions and neurological or mental health disorders. This is because the symptoms of PANS/PANDAS may also be present in other mental health disorders, and there is an overlap that can make it challenging to pinpoint the exact cause. A physician well-versed in PANS and PANDAS should conduct a hands-on physical examination to ensure the symptoms are not the result of other serious medical conditions, including rheumatic fever, acute brain infections, or autoimmune encephalopathy.
In addition to a physical examination, lab tests can guide healthcare professionals in the right direction for diagnosing and treating PANS/PANDAS. Blood work can serve as a helpful diagnostic tool, and biological markers can provide additional evidence to confirm a diagnosis. Doctors may conduct blood work and other in-office tests to assess a patient's condition. A total basic blood workup may include IgE, IgA, IgM, and IgG antibodies, antinuclear antibodies (ANA), a complete blood count (CBC), ferritin (iron), B12, and vitamin D. In addition to basic blood work, viral and bacterial testing for strep throat is important, as some children with PANDAS can react to exposure to strep.
The Cunningham Panel, developed by Dr. Cunningham, consists of five individual tests that assess autoimmune antibody levels. These tests are for the dopamine D1 receptor, dopamine D2L receptor, lysoganglioside GM1, tubulin, and CaM kinase II. Elevated levels on one or more of these tests indicate that a child’s neuropsychiatric symptoms may be due to a treatable autoimmune disorder possibly triggered by an infection.
In summary, while there is no single test to diagnose PANS or PANDAS, a combination of clinical evaluations, laboratory tests, and a detailed review of medical history are necessary to rule out other disorders and establish a correct diagnosis and treatment plan. A physical examination is a crucial component of this process to ensure that other serious medical conditions are not the cause of the symptoms.
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Frequently asked questions
PANS stands for "Pediatric Acute-Onset Neuropsychiatric Syndrome", while PANDAS stands for "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections". PANS and PANDAS are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other distressing symptoms.
The primary symptoms of PANS and PANDAS include OCD and/or severe eating restrictions, accompanied by additional secondary symptoms such as tics, changes in normal behaviours, personality and mood, decreased cognitive ability, anxiety, and sleep and urinary disturbances.
There is no single blood test or scan that can diagnose PANS or PANDAS. Diagnosis requires expert clinical knowledge, a careful history, and a hands-on physical examination by a physician well-versed in PANS and PANDAS. Lab tests, such as the Cunningham Panel, can guide healthcare professionals in the right direction for diagnosis and treatment.
PANS and PANDAS can be treated with medicines and therapy, such as cognitive behavioural therapy. Doctors and mental health experts can also provide guidance and support to help families get through challenging times.
PANDAS is caused by a Group A strep infection, such as scarlet fever, strep throat, or rheumatic fever. PANS cases have also been linked to other infections, including Lyme disease, mononucleosis, mycoplasma (walking pneumonia), and the flu.
