PANS-PANDAS, case report

Introduction

Since 1980, there have been known cases of childhood neuropsychiatric syndromes in the world and its concept has evolved with changes in the definitions in 1995 (PITANDs — paediatric infection-triggered autoimmune neuropsychiatric disorders), 1998 (PANDAS — paediatric autoimmune neuropsychiatric syndrome associated with streptococci infection), 2010 (PANS — paediatric acute-onset neuropsychiatric syndrome) and 2012 (CANS — childhood acute neuropsychiatric syndrome). Despite being known for more than 20 years, it is still an illness that often goes unnoticed by many health professionals.

Objective

To sensitise the medical community about the identification of the disease and reduce the morbidity associated with a late diagnosis.

Clinical case

A 6-year-old schoolgirl brought to the emergency department due to her refusal to eat. In the hospital treatment, a clinical history was identified with PANS-PANDAS diagnostic criteria. She exhibited a relapsing-remitting clinical course, as described in the literature, with poor response to first-line treatments.

Conclusions

In all school-age child presenting with obsessive compulsive disorder or eating disorders, with other symptoms or not, a possible link to PANS-CANS should be evaluated and ruled out.