PANS and PANDAS are diagnoses made based on both clinical and laboratory studies, as opposed to diagnoses based on a single imaging or laboratory finding.
A “clinical diagnosis” refers to a diagnosis that’s made based on the signs (what a doctor observes) and symptoms (what the patient reports) presented by a patient, as well as the doctor’s knowledge and clinical experience. The process often involves taking a patient’s history, obtaining vital signs, and considering the overall clinical picture. For some diseases or conditions, a clinical diagnosis might be all that’s needed if the signs and symptoms are distinctive and characteristic of a specific condition.
On the other hand, a diagnosis based on labs alone relies on laboratory tests such as blood tests, urine tests, imaging studies, biopsies, or other diagnostic procedures. These lab-based diagnoses are often more objective because they rely on measurable data. They are particularly useful for confirming or ruling out certain conditions that cannot be accurately diagnosed based on signs and symptoms alone, or when the clinical picture is not clear.
In reality, medical practice, especially in the realm of PANS and PANDAS often combines both of these approaches. The clinical diagnosis usually forms the initial impression which then guides which lab tests to order. These tests either confirm the clinical suspicion or provide more data to refine the diagnosis. For some diseases or conditions, definitive diagnosis requires specific lab tests or imaging studies. In those cases, the clinical diagnosis is more of a “working diagnosis” or “differential diagnosis” that needs to be confirmed with additional testing.
This two-pronged approach allows for a more comprehensive understanding of the patient’s condition and helps guide the most effective treatment strategy.