PANS or PANDAS

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Specializes in kids.

Anyone have kids with this dx? I have student who was dxd in 3rd  grade (now 9th) w/Lyme. Has had terrible attendance  since then (Lyme is not currently active to the best of my knowledge) but has had awful strep and tonsillitis this year several times and is scheduled for T&A soon. Considering bring this up to parent. School avoidance seems to be an issue and I ? is the anxiety piece is involved there? Lots of Mondays missed. Not sure how receptive mom will be...not sure if I am on the right track even.

 

Appreciate your wisdom and knowledge!!

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Specializes in pediatrics, school nursing.

I have experienced diagnosed PANDAS 3x in my career; Each time, the students became severely aggressive or present with severe OCD-like tendencies, but only during active infection. All 3 patients were at one time involved in the PANDAS research program at MGH (https://www.massgeneral.org/children/pediatric-neuropsychiatry-and-immunology) and taking prophylactic antibiotics and/or antipsychotics. I am not sure if general anxiety/school avoidance would count, especially if it isn't during active infection. 

A lot of chronic strep does seem to be centered around the bacteria getting caught in the tonsils, so hopefully the T&A will help with that... Adenoids have less chance of re-emergence (I guess the younger the kid with the T&A, the more chance they can regrow!), so hopefully the chronic strep will clear up, too... 

If the avoidance/anxiety increased, it might be better to consider an attendance contract, if that is something your school/district does!

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Specializes in kids.
1 minute ago, k1p1ssk said:

I have experienced diagnosed PANDAS 3x in my career; Each time, the students became severely aggressive or present with severe OCD-like tendencies, but only during active infection. All 3 patients were at one time involved in the PANDAS research program at MGH (https://www.massgeneral.org/children/pediatric-neuropsychiatry-and-immunology) and taking prophylactic antibiotics and/or antipsychotics. I am not sure if general anxiety/school avoidance would count, especially if it isn't during active infection. 

A lot of chronic strep does seem to be centered around the bacteria getting caught in the tonsils, so hopefully the T&A will help with that... Adenoids have less chance of re-emergence (I guess the younger the kid with the T&A, the more chance they can regrow!), so hopefully the chronic strep will clear up, too... 

If the avoidance/anxiety increased, it might be better to consider an attendance contract, if that is something your school/district does!

Thx the more I read the less I think it might be this...I do not believe there is an OCD part to this and that certainly seems to be the prevalent although not only symptom.

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