Evidence map›Paper›PMID 39448979›Full record

ArticleBMC psychiatry2024

PANDAS, a series of difficult decisions: a case report.

Michael Wang, Randall Ricardi, Gaby J Ritfeld

Abstract readCase Reports
In one paragraph

Article in BMC psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Michael WangDepartment of Psychiatry, Creighton University School of Medicine, Phoenix, AZ, USA. michael.wang2@med.usc.edu.
Randall RicardiDepartment of Psychiatry, Creighton University School of Medicine, Phoenix, AZ, USA.
Gaby J RitfeldDepartment of Psychiatry, Creighton University School of Medicine, Phoenix, AZ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS) is a controversial diagnosis with limited evidence-based treatment guidelines available, particularly for severe and treatment-resistant cases. CASE PRESENTATION: This report describes a 9-year-old male presenting with sudden onset, severe obsessive-compulsive disorder (OCD) symptoms one month following a streptococcus infection. His symptoms included suicidality and recurrent self-injurious behaviors, which led to multiple inpatient hospitalizations. He was diagnosed with PANDAS and was treated with psychotropic medications, antibiotics, immunotherapy, and a tonsillectomy. Over the two years since initial admission, the patient's condition improved, with a decrease in symptom severity and an increase in adaptive functioning, though symptom remission was slow to occur.

conclusionsThis paper explores the controversies surrounding the PANDAS diagnosis, reviews potential treatments, and discusses the dilemmas of medical decision-making in the setting of severe treatment-resistant symptoms and limited evidence-based guidelines. We hope that this case report will be valuable to healthcare providers facing similar presentations and inspire further investigation into this complex condition.

Indexed as

Autoimmune DiseasesObsessive-Compulsive DisorderStreptococcal InfectionsAnti-Bacterial AgentsChildHumansImmunotherapyMaleSelf-Injurious BehaviorTonsillectomyAnti-Bacterial AgentsAntibiotic prophylaxisIntravenous immunoglobulinObsessive-compulsive disorderPANDASPediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infectionsSelf-harmSuicidalityTic disorderTonsillectomy

Identifiers

PMID39448979
PMCPMC11515437

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.