Current knowledge of PANDAS and PANS syndromes in paediatric patients – etiology, diagnosis and therapies

Introduction and Objective. PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with StreptococcalInfections) and PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) are rare diseases and there is scant information about diagnostic and treatment options.The aim of this study is to summarise the current state of knowledge about the diseases.Review Methods.Articles from the PubMed database were sought and articles found dealing with the diseases were summarised and the knowledge assessed.Brief description of the state of knowledge.The etiology of PANDAS and PANS syndromes has not yet been defined.There are hypotheses assuming that streptococcal infection can trigger an immune response that results in prominent neuropsychiatric symptoms.Diagnostic criteria focus on a clinical picture that includes the sudden onset of tics, obsessivecompulsive behaviour, anxiety and mood disorders following infection.Therapy for PANDAS and PANS syndromes is based at present on a number of therapeutic avenues for selecting the best plan.Immunomodulatory therapies, such as plasmapheresis and immunoglobulin administration, are being explored as methods to reduce the severity of the intractable symptoms in children.In addition, behavioural and pharmacological therapies, such as antipsychotics or anticonvulsants, are being used to manage symptoms.Summary.Despite the clear interest in understanding these syndromes, there is a need for further research, especially in the area of identifying pathomechanisms and optimal treatment strategies.Improving diagnostic and therapeutic processes will ensure faster recovery and prevention of these conditions in paediatric patients in the interest of their well-being and comfort.