Selecting a Treatment Regimen
Pediatric Autoimmune Neuropsychiatric Disorders
Associated with Streptococcal Infection (PANDAS)
PANDAS is defined as the abrupt onset or exacerbation of a tic or obsessivecompulsive disorder (OCD) in prepubertal children, considered to be triggered by a
Group A β-hemolytic streptococcal infection, but there is controversy in the medical
community regarding this syndrome as a disease entity.
ÎÎThere is insufficient evidence to support or refute the use of
plasmapheresis in the treatment of acute OCD and tic symptoms in the
setting of PANDAS (Level U).
Sydenham Chorea
ÎÎThere is insufficient evidence to support or refute the use of
plasmapheresis in the treatment of Sydenham chorea (Level U).
Table 1. Summary of Evidence
Disease
Conclusion
Quality
Acute Inflammatory Demyelinating
Polyneuropathy/Guillain-Barré Syndrome
Established effective
Class I
Chronic Inflammatory Demyelinating
Polyneuropathy, short-term treatment
Established effective
Class I
Polyneuropathy with monoclonal gammopathies of undetermined significance
IgA/IgG
Probably effective
Class I
Probably ineffective
Class I
Pre-op Preparation
Insufficient evidence
Class III
Crisis
Insufficient evidence
Class III
Possibly effective
Class II
Established ineffective
Class I
Probably effective
Class I
IgM
Myasthenia Gravis
Fulminant Demyelinating CNS Disease
Chronic Progressive MS
Relapses in MS
Sydenham Chorea
Class III
Acute OCD and Tics in PANDAS
2
Insufficient evidence
Insufficient evidence
Class III
