PANS Case Report. Assessment and management implications for a Liaison Child Psychiatry Program

Abstract

Introduction Pediatric acute-onset neuropsychiatric syndrome (PANS) was described in 2010 not related to streptococcus infection (as PANDAS is), and with a clinically distinct presentation, defined as: I) Abrupt, dramatic onset of obsessive-compulsive disorder or severely restricted food intake; II) Concurrent presence of additional neuropsychiatric symptoms; III) Symptoms are not better explained by a known neurologic or medical disorder. Objectives To describe the clinical features in a scholar boy who suffered an abrupt obsessive-compulsive disorder and highlight the need of an specific medical and psychiatric assessment and management from a multidisciplinary perspective. Methods Clinical case: A 7-year-old boy brought to the emergency department due to his repetitive and hyperactive behavior. After the admission in the hospital a clinical history was identified with PANS diagnostic criteria. He presented repetitive language and ritualized behavior, emotional lability and hyperactivity that has begun in an abrupt manner in the last 5 days. Family history, medical history and physical examination, infectious disease evaluation, neurological assessment and child psychiatric assessment were carried out during hospitalization. Coordination between neuropediatric consultant and child psychiatry was necessary. Results Combinated treatment, psychofarmacologic and psychotherapeutic, was effective and the symptoms disapeared gradually in about three months. Conclusions In all school-age child presenting with abrupt obsessive-compulsive disorder or eating disorders a possible link to PANS should be evaluated and rule out. It is important a Liaison Child Psychiatry program for a complete multidisciplinary evaluation and management of these patients. Disclosure of Interest None Declared