MULTIDOMAIN SYMPTOM FEATURES IN A PANS/PANDAS-LIKE PE-DIATRIC SUBGROUP WITH RECENT STREPTOCOCCAL EXPOSURE

Abstract

Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) describe debated pediatric neuropsychiatric presentations in which immune-mediated neuroinflammatory mechanisms have been proposed in at least a subset of cases. PANDAS is temporally linked to streptococcal infection, whereas Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is broader and may follow infectious or non-infectious triggers. Materials and methods: This secondary exploratory study described Pediatric Acute-onset Neuropsychiatric Syndrome 31-Item Symptom Rating Scale (PANS-31) item-level findings in a pediatric psychiatric cohort. The source cohort included 96 children and adolescents evaluated through inpatient or outpatient child psychiatric services for neuropsychiatric symptoms and caregiver- or record-supported history suggestive of previous streptococcal exposure. Results: For the present descriptive comparison, 36 children simultaneously had antistreptolysin O (ASO) >200 IU/mL, reported <6-month streptococcal infection and abrupt symptoms onset or worsening; the remaining 60 participants formed the comparison group. Individual PANS-31 item scores were compared using Mann–Whitney U tests, rank-biserial effect sizes and Benjamini–Hochberg false discovery rate correction. Conclusions: Children meeting the three criteria showed higher scores for selected symptoms, especially dysgraphia/writing deterioration, motor tics, enuresis, cognitive/memory deficit, school-performance decline and affective/anxiety-related symptoms. These findings support a careful symptom-by-symptom description in suspected post-streptococcal neuropsychiatric presentations, without defining a diagnostic subtype or a new clinical score.