Treatment of PANDAS and PANS: a systematic review

@article{Sigra2018TreatmentOP,
  title={Treatment of PANDAS and PANS: a systematic review},
  author={Sofia Sigra and Eva Hesselmark and Susanne Bejerot},
  journal={Neuroscience \& Biobehavioral Reviews},
  year={2018},
  volume={86},
  pages={51-65}
}
HighlightsWe conducted a systematic review of treatments for PANDAS and PANS.Twelve studies comprising 529 patients and a total of 240 case reports were identified.Evaluated treatments were IVIG, TPE, antibiotics, CBT and tonsillectomy.The studies generally have a high risk of bias and results were inconclusive.The treatments identified as promising in case reports need to be further evaluated. &NA; Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS… 
Clinical Features in Patients With PANDAS/PANS and Therapeutic Approaches: A Retrospective Study
TLDR
In fact, irritability, aggressivity, and food restriction were significantly more frequent in children with PANS and the levels of anti-streptolysin O and anti-DNAse B were higher in PANDAS.
PANS and PANDAS: Case series of patients in a Danish pediatric clinical cohort.
TLDR
A positive effect of acute and prophylactic antibiotic-, psychiatric- and immunomodulating treatment, according to parental reports is shown.
PANS/PANDAS: Clinical Experience in IVIG Treatment and State of the Art in Rehabilitation Approaches
TLDR
Evaluated clinical features of the patients observed from different Italian cohorts, with the attempt at evaluating clinical response to IVIG treatment in children with an extreme severity grade of PANS/PANDAS disease, and proposes rehabilitation therapy as an added value to the pharmacological treatment.
Diagnosis in PANDAS: An Update
TLDR
This review offers a compilation of the most important studies performed to date regarding the clinical presentation and potential biological markers of PANDAS, and suggests the refinement of some aspects in the current diagnosis criteria.
Anti-inflammatory, antibacterial and immunomodulatory treatment in children with symptoms corresponding to the research condition PANS (Pediatric Acute-onset Neuropsychiatric Syndrome): A systematic review
TLDR
Very low certainty of Evidence of beneficial effects, and moderate certainty of evidence of adverse effects, of anti-inflammatory, antibacterial or immunomodulating treatments in patients with symptoms corresponding to the research condition PANS are revealed.
Patient Satisfaction and Treatments Offered to Swedish Patients with Suspected Pediatric Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
TLDR
It was more common that patients had received antibiotics than common psychiatric treatments for their psychiatric symptoms, and higher patient satisfaction was associated with global clinical improvement.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (Review)
TLDR
A thorough review of the literature was carried out using the PubMed database and SCOPUS, searching for immunological, clinical and microbiological aspects, as well as the treatment of the PANDAS syndrome, to establish the best method of therapy.
Anti-inflammatory Augmentation Therapy in Obsessive-compulsive Disorder: A Review
Obsessive-Compulsive Disorder (OCD) is considered as a serious disabling psychiatric disorder, influencing 2-3% of the total general population, with an unknown etiology. A comprehensive
Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS.
TLDR
Caregivers reported a decreasing frequency of symptoms over time regardless of treatment and had no difference in satisfaction, suggesting T&A in combination with antibiotics should be considered as an early intervention for PANDAS.
Azithromycin Prophylaxis in an Adolescent With PANDAS.
TLDR
A background and case of PANDAS exacerbation in an adolescent patient, who presented with visuomotor impairment and was treated with azithromycin (Zithromax, Pfizer, New York, NY) prophylaxis to prevent further clinical deterioration, is described here.
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