5975 Enuresis as a presentation of paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS)

Objectives To explore the prevalence of urinary symptoms in a UK cohort of children with PANDAS between August 2021 and September 2022. Methods We conducted a retrospective clinical review of 109 children aged 4–19 years with PANDAS from August 2021 to September 2022 with analysis from a paediatric consultant, patients and parents. All subjects met NIMH criteria for diagnosis of PANDAS including the sudden onset of movement disorder (tics), OCD, enuresis, anxiety and other symptoms alongside evidence of prior streptococcal infection.¹ Treatment involved antibiotics, anti-inflammatory drugs, and corticosteroids with outcomes categorized by parent interview into excellent, very good, good and poor response. Results Data from 109 children aged <19 years, all meeting NIMH criteria for PANDAS were analysed. There were 49 females and 61 males (M:F ratio = 1.2:1) and there were 101 white Caucasians (92.7%), 5 Asians (4.5%) and 3 Afro-Caribbeans (2.8). Out of the total cohort of 109 children, 56 patients (51%) had enuresis as a presenting symptom alongside their PANDAS symptoms. Conclusion Enuresis is a common presentation of children with PANDAS (observed in 51% of cases). Early recognition of enuresis is important in promptly identifying PANDAS cases allowing prompt investigation and treatment. References Thienemann M, Murphy T, Leckman J, Shaw R, Williams K, Kapphahn C, et al. Clinical management of pediatric acute-onset neuropsychiatric syndrome: part I- psychiatric and behavioral interventions. Journal of Child and Adolescent Psychopharmacology. [Review]. 2017 Sep;27(7):566–73. Swedo SE, Leonard HL, Garvey M, Mittleman B, Allen AJ, Perlmutter S, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. The American Journal of Psychiatry. 1998 Feb;155(2):264–71.