If your child has been diagnosed with PANDAS, you may feel like you're navigating an emotional rollercoaster, trying to manage the sudden symptoms that come with it. This pediatric autoimmune neuropsychiatric disorder is characterized by a postinfectious autoimmune response, where the immune system mistakenly targets the brain, leading to severe symptoms.
PANDAS is like an unexpected storm, bringing a whirlwind of obsessive-compulsive disorder (OCD), tics, and other neuropsychiatric symptoms.
As a parent, watching your child struggle with these severe symptoms can be heart-wrenching and overwhelming, leaving you searching for effective solutions to help them regain their normalcy and joy.
What is PANDAS?
(Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)
PANDAS is the result of a postinfectious autoimmune response, where antibodies, meant to combat Group A streptococcal bacteria, take a detour and attack brain tissues instead. While strep infections like strep throat are the usual suspects, other bacterial, viral, or environmental triggers can also crash the party. Affecting about 1 in 200 children, PANDAS doesn’t do things by halves—its symptoms range widely and often make a grand entrance.
Children with a history of rheumatic fever are at a higher risk of experiencing a sequel performance of symptoms, making prophylactic antibiotics a crucial act in preventing encore relapses.
Children with a history of rheumatic fever are at a higher risk of experiencing a sequel performance of symptoms, making prophylactic antibiotics a crucial act in preventing encore relapses.
Plasmapheresis for PANDAS as a Treatment Option
One of the most promising treatments for PANDAS and other neurological disorders is plasmapheresis, an invasive procedure also known as plasma exchange or therapeutic apheresis. This procedure removes the plasma—the part of the blood containing proteins and immune components like antibodies—and replaces it with albumin or donor plasma. The red and white blood cells and platelets are then returned to the body.
Plasmapheresis, or plasma exchanges, is particularly effective in autoimmune disorders. It helps eliminate harmful antibodies and toxins that contribute to the condition. In the case of PANDAS, plasmapheresis is often paired with other treatments for infectious diseases, such as IVIG (intravenous immunoglobulin) and antibiotics, to maximize its benefits.
Assessing Treatment Options for PANDAS
Treating PANDAS requires a customized approach, as every child responds differently. Options include:
- Plasmapheresis removes harmful antibodies and resets the immune system.
- IVIG therapy to modulate immune function.
- Antibiotics are often used initially to manage neuropsychiatric symptoms caused by brain inflammation caused by infections. This treatment can lead to rapid improvements.
- Prophylactic antibiotics are also important to prevent future infections and relapses.
- Neurofeedback and PEMF Therapy to regulate the brain and nervous system
At my Ridgefield, CT clinic, I assess treatment options using a comprehensive approach tailored to each child’s needs. This includes a detailed review of their medical history, symptoms, and triggers, as well as advanced tools like QEEG brain mapping to evaluate brain function.
How Therapeutic Plasma Exchange Works
Plasmapheresis is a hospital-based procedure that removes plasma from the blood, filters out harmful substances, and replaces it with a sterile solution. After the plasma is removed, red blood cells, along with other components like white blood cells and platelets, are returned to the body.
- In younger patients, a central line is often required for the procedure.
- For older children or those with suitable veins, plasmapheresis can be performed peripherally.
Why does it work?
Plasmapheresis restores balance to the immune system by removing circulating antibodies and toxins, paving the way for recovery. Plasmapheresis offers rapid symptom relief, providing a much-needed reprieve.
Many PANDAS patients have reported marked improvements in symptoms following plasmapheresis treatment. These improvements often include enhanced behavior and emotional regulation, which are observed shortly after undergoing the procedure.
Plasmapheresis is used in PANS treatment for several reasons:
Safety and Efficacy of Plasmapheresis
When performed by trained medical professionals, plasmapheresis is generally safe. However, as with any medical procedure, there are potential risks, including bleeding, infection, or allergic reactions. Adverse events can occur during plasmapheresis, such as vasovagal episodes and cutaneous paresthesias.
The efficacy of plasmapheresis in treating PANDAS is supported by research. A study in the Journal of Clinical Apheresis found that children who underwent plasmapheresis experienced a 65% reduction in symptoms within six months of initial treatment, with further improvements of up to 78% at long-term follow-up. While these results are encouraging, more research is needed to fully understand its long-term benefits and safety profile.
A Holistic Approach for PANS / PANDAS
When it comes to managing PANDAS, you can’t just apply one treatment and hope for the best—it takes a team effort and a whole lot of TLC. A holistic approach that includes nutritional and lifestyle changes can make a world of difference. We're talking about anti-inflammatory diets (goodbye, sugar overload!), consistent sleep routines, and kicking those sneaky environmental toxins to the curb.
Let me tell you about Ella, a spirited 9-year-old who went from being the life of the classroom to battling daily meltdowns and relentless OCD rituals and tics practically overnight. Her parents were desperate—trying antibiotics, therapy, and even supplements—but the needle barely moved. That’s when they decided to go all-in with a holistic approach.
Working closely with a PANDAS specialist, they revamped Ella’s diet to focus on anti-inflammatory foods like leafy greens, salmon, and turmeric smoothies. They got serious about screen-free evenings and added magnesium-rich baths to her bedtime routine. Over time, the meltdowns eased, and her personality began to shine again. “It was like we got our Ella back,” her mom said, fighting back tears of relief.
Here’s the kicker: collaboration is everything.
Connecting with a healthcare professional experienced in PANDAS ensures you’re targeting the right treatments for your child’s unique needs. Whether you combine dietary shifts with neurofeedback or create a toxin-free home environment, this partnership can lead to real, life-changing results.
Because at the end of the day, it’s not just about managing symptoms—it’s about helping your child reclaim their joy, health, and childhood.
Ready to learn more? Start your journey with my Natural PANS/PANDAS Calm Brain Kit, and discover actionable steps to calm your child’s brain and restore peace to your family.
What is plasmapheresis used for?
The separation of white blood cells from the blood is called plasmapheresis. It treats autoimmune disorders by removing antibodies or harmful substances from the blood plasma. It's also utilized in managing acute conditions like Guillain-Barré syndrome, myasthenia gravis, and certain types of vasculitis.
Is plasmapheresis safe?
Plasmapheresis is generally considered safe when performed by trained medical professionals, but like any medical procedure, it carries potential risks such as bleeding, infection, or allergic reactions to the replacement fluids used. The benefits and risks should be carefully weighed based on individual patient circumstances and medical needs.
What diseases are treated with plasmapheresis?
Plasmapheresis is used to treat a variety of autoimmune disorders such as Guillain-Barré syndrome, myasthenia gravis, and certain types of vasculitis. It can also be employed in managing acute conditions like thrombotic thrombocytopenic purpura (TTP) or in removing harmful substances from the blood in cases of poisoning or overdose.
What is plasmapheresis and when is it done?
Plasmapheresis is a medical procedure where blood plasma is removed from the body and separated from blood cells, then the plasma is filtered or replaced before returning the blood to the body. It is typically done to treat autoimmune diseases, neurological disorders, and certain toxicological emergencies by removing harmful substances or antibodies from the plasma.
How does the body replace blood?
The body replaces blood through hematopoiesis, primarily in the bone marrow. Stem cells in the bone marrow continuously divide and differentiate into various blood cells, including red blood cells, white blood cells, and platelets, replenishing the blood supply as needed.
What is the liquid part of the blood called?
The liquid part of the blood is called plasma. It constitutes about 55% of the total blood volume and serves as a medium for transporting nutrients, hormones, and waste products throughout the body.
How is plasmapheresis done?
Plasmapheresis is a procedure in which blood is removed from the body through a vein and passed through a blood separation machine. The plasma is either filtered to remove harmful substances or replaced with a substitute solution before being returned to the body and the blood cells.
Is plasma exchange dangerous?
The plasma exchange treatment is generally safe when performed by trained healthcare professionals, but it carries potential risks such as low blood pressure, allergic reactions, infection, blood clots, and electrolyte imbalances. Patients considering plasma exchange should discuss the possible risks and benefits with their healthcare provider and ensure proper monitoring during and after the procedure.
Are there plasmapheresis side effects?
Yes, there can be plasma exchange side effects, such as low blood pressure, allergic reactions, infection, blood clots, and electrolyte imbalances. Patients should discuss the potential risks and benefits with their healthcare provider before undergoing a plasmapheresis procedure.
Is there a difference between plasmapheresis vs plasma exchange?
Plasmaphereses and plasma exchange are used interchangeably to describe the same medical procedure. Both involve the removal, treatment, and return of blood plasma, typically for therapeutic purposes.
Citations
Barzman, D. H., Jackson, H. S., Singh, U., Griffey, M., Sorter, M. T., & Bernstein, J. A. (2018). An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment. Case Reports in Psychiatry, 2018, 1–5. https://doi.org/10.1155/2018/8189067
Madore, F. (2002). Plasmapheresis. Critical Care Clinics, 18(2), 375–392. https://doi.org/10.1016/s0749-0704(01)00010-0
Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:
- Autism W/ Dr. Andy McCabe Radio Show Topic: Autism, PANS/PANDAS
- Biofeedback Certification International Alliance (BCIA) Webinar Neurofeedback & Lyme
- Clearly Clinical Podcast: What you need to know about PANS/PANDAS
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.
She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).
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