PANS/PANDAS

Differential diagnoses for PANS/PANDAS include OCD, anorexia nervosa, Tourette syndrome, bipolar disorder, autoimmune encephalitides, and Wilson's disease. PANS and PANDAS are described as clinical diagnoses that are strongly associated with Bartonella co-infection in children. The article presents blood-brain barrier disruption and neuroinflammation as the mechanism behind PANS/PANDAS. PANDAS is strongly tied to Streptococcal infection, while PANS can involve additional infectious triggers. IVIG is described as the standard of care for moderate-to-severe PANS/PANDAS. The Cunningham Panel is presented as an option when standard labs are negative but clinical suspicion remains high.