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

Frontiers in Pediatrics

Pediatrics

Jens Eickhoff¹  Richard P. Morse²  Michael V. Heinz³  Alisha Agrawal³  Juliette C. Madan⁴  Aravindhan Veerapandiyan⁵  Daniel Liu⁵  Ellen R. Wald⁶  Veronica M. Raney⁷  Grace E. Flood⁸ 

[1] Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States;Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States;Department of Pediatrics, Children’s Hospital at Dartmouth, Geisel School of Medicine at Dartmouth, Hanover, NH, United States;Department of Pediatrics, Children’s Hospital at Dartmouth, Geisel School of Medicine at Dartmouth, Hanover, NH, United States;Department of Psychiatry, Children’s Hospital at Dartmouth, Geisel School of Medicine at Dartmouth, Hanover, NH, United States;Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States;Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States;Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States;Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States;Medical Director Clinical Analytics and Reporting, University of Wisconsin, Madison, WI, United States;

关键词: PANS;    PANDAS;    group A streptococcus;    obsessive-compulsive disorder;    food restriction;    epidemiology;   

DOI  :  10.3389/fped.2023.1170379

 received in 2023-02-23, accepted in 2023-09-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

Unknown   
© 2023 Wald, Eickhoff, Flood, Heinz, Liu, Agrawal, Morse, Raney, Veerapandiyan and Madan.