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Dear Doctor,

I’m sure you’re aware that back in 2012, PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) was formally proposed and described in a white paper by a small handful of physicians who had extensive expertise in PANDAS. While this was welcome news to those who recognized that the neuropsychiatric features seen in PANDAS were also seen in the absence of strep, the decision to focus on acute onset in children over the age of two was not based upon any biomarker or science that would lend credibility to the theory that the pathogenesis of the described syndrome was unique solely to children meeting the diagnostic criteria set forth in the paper.

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