Estimate of the incidence of PANDAS and PANS in 3 primary care populations

• Main Authors: Ellen R. Wald (Author), Jens Eickhoff (Author), Grace E. Flood (Author), Michael V. Heinz (Author), Daniel Liu (Author), Alisha Agrawal (Author), Richard P. Morse (Author), Veronica M. Raney (Author), Aravindhan Veerapandiyan (Author), Juliette C. Madan (Author)
• Format: Book
• Published: Frontiers Media S.A., 2023-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

ObjectivePediatric 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.MethodsWe 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.ResultsThe 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.ConclusionOur 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.

Item Description

2296-2360
10.3389/fped.2023.1170379