A story in Sunday's Wall Street Journal highlights Stanford's leadership in treating a mystifying disease in which a child suddenly develops intense psychiatric problems, often after an infection. The disease, called pediatric acute-onset neuropsychiatric syndrome, can be terribly disabling, altering kids' personalities, interfering with their school work and making it hard for families to function.
As the story (subscription required) explains, some physicians question whether PANS is actually a separate disease from the psychiatric diagnoses it resembles, which include obsessive-compulsive disorder and anorexia nervosa. But doctors at Lucile Packard Children's Hospital Stanford suspect something else is truly going on, likely an autoimmune attack on the brain. The team, led by Jennifer Frankovich, MD, and Kiki Chang, MD, is working to learn more about the disease:
In an effort to establish the science of PANS, the Stanford clinic is collecting extensive data on the patients. Doctors try to piece together what is driving symptoms from pediatric records, parent reports, even teacher interviews. They are analyzing DNA samples from each patient and looking for clues in their immune systems. If they find strep, they bank the strain for further research. "It is easier to study something that is established," Dr. Frankovich said. "To build something new is really hard."
The team's insights from 47 of their patients were published earlier this year in a special PANS-focused issue of the Journal of Child and Adolescent Psychopharmacology, and the researchers are currently working to expand the capacity of their PANS clinic, the first of its kind in the country. More information about PANS and its effect on children and families is also available in a Stanford Medicine magazine story I wrote last year about Frankovich and Chang's work.
Previously: What happens when the immune system attacks the brain? Stanford doctors investigate and My descent into madness -- a conversation with author Susannah Cahalan
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