89 Frequency and Impact of PANDAS/PANS Diagnosis in Canada

Abstract Background Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS/PANS) are defined by abrupt onset and episodic course of symptoms infection. There challenges in the application published diagnostic criteria, frequency diagnosis is unknown. To date, there little data on clinical practice patterns diagnosis, assessment treatment. Objectives The aim this study was to estimate characterize impact label PANDAS/PANS Canada. Design/Methods Through established CPSP methodology, over 2,800 paediatricians subspecialists were surveyed for children seen previous month who had received PANDAS/PANS. Respondents completed a detailed questionnaire demographics, presentation, evaluation interventions. Results Between December 1, 2019 November 30, 2021, 84 reported cases majority female (48/84, 57%), mean age symptom 9.4 years (range 3 16 years). Of cases, 82% (69/84) OCD and/or acute food refusal, 39% (33/84) tics 32% (27/84) both tics. Symptom described as sudden 22% cases. vast at least two (80/84, 95%). Infection (22/84, 26%) or exacerbation (25/84, 30%) less than one-third Healthcare utilization included emergency-department visits (29/84, 35%) inpatient admissions, medical (8/84, 10%) psychiatric 10%). Three quarters (52/68, 76%) five more health care since 31% (24/78, 31%) accessed providers. Medical treatments provided 95% (80/84; antibiotics, NSAIDS, steroids, IVIG rituximab), (80/84) psychological treatments, 50% (42/84) patients saw complementary/alternative provider. Almost all (84/85) experienced significant negative impacts, including family stress, mental concerns, conflict (54/84, 64%); school absences (43/84, 51%); withdrawal from activities/friends (33/84, 39%). In forty-one percent (33/81) discrepancy certainty families significantly certain reporting physicians. Conclusion rare diagnoses, burden children, healthcare system. variation treatment, frequent uncertainty about diagnosis. Education guidelines needed, targeting range practitioners.