Advice for GP’s

If a previously fit and well child presents with sudden onset of tics, OCD, urinary frequency or difficulty swallowing you should consider a diagnosis of PANDAS and PANS alongside your normal differentials. We would recommend the following investigations to be done at presentation: FBC, U+E, LFT, CRP, ASOT, Anti-Dnase B, Mycoplasma titres, Total IgE, Vitamin D, Anti-nuclear antigen(ANA), TFT, Immunoglobulins and Immunoglobulin sub-sets. If there is a history of abdominal symptoms also consider doing a test for coeliac disease.
Treatment should be started if the clinical suspicion is high. We initially start with Co-amoxiclav or if penicillin allergic consider using azithromycin. Response to treatment is important in the overall assessment of the child.