Diagnosing Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) can be a complex process. This blog aims to guide you through the various tests and evaluation methods used for diagnosing PANDAS.
Clinical History and Physical Examination
The first step in diagnosing PANDAS involves a thorough medical history, including symptoms at disease onset, exposure to infections, episodes of fever, and the presence of psychiatric disorders in the family. Physical and neurological examinations are performed by a child neuropsychiatrist with expertise in movement and psychiatric disorders1.
Antistreptolysin O (ASO): This test measures antibodies produced in response to a streptococcal infection. A level of 200 international units (IU)/mL suggests streptococcal infection.
Anti-Deoxyribonuclease B (Anti-DNAse B): Another marker for streptococcal infection, with a threshold of 150 IU/mL1.
Additional Diagnostic Criteria
The diagnosis of PANDAS is often based on clinical criteria and is considered an exclusionary diagnosis with respect to other neurological and psychiatric disorders. The most common symptoms include tics and obsessive-compulsive disorder (OCD). Other symptoms like anxiety, irritability, and aggressivity may also be present1.
A high percentage of relatives with neuropsychiatric diseases, including bipolar disorder and OCD, can also be an indicator for PANDAS1.
Diagnosing PANDAS involves a multi-faceted approach, including clinical history, physical examination, and laboratory tests. If you suspect your child may have PANDAS, consult a healthcare provider for a comprehensive diagnosis and treatment plan.