Hidden autoimmune diseases affect our children: Understanding Panth and Pandas
When Buckley Tant was six years old, his world (and his family) began to collapse. Diagnosed with ADHD and later on opposition disorder, Buckley is a smart child whose behavior becomes unstable, aggressive and frightening. His parents exhausted all their possible resources: psychiatric drugs, behavioral interventions and homeschooling, without relief. It wasn’t until the age of 9 that Barkley was eventually diagnosed with pediatric acute neuropsychiatric syndrome (PANS), a little-known autoimmune disease that mimics behavior and psychosis. At that time, Barkley spent years in isolation from his classmates, misunderstood by his teacher, and fell into a medical system that could identify his condition.
Today, Buckley is 90% better with treatments performed in supportive, faith-centric environments. He returned to school to flourish. But unfortunately, his story is not unique and does not end.
What are pots and pandas?
PANS and its subgroups, autoimmune neuropsychiatric diseases in children are associated with streptococcal infection (PANDAS) and are autoimmune diseases triggered by infections such as streptococcal throat. They cause fire in the immune system, attack brain cells and lead to rapid attacks of obsessive-compulsive disorder, anxiety, anger, tics, food restrictions, and cognitive decline.
These diseases are usually still underestimated, and it is estimated that 1 in up to 200 children in the United States is affected. New cases and symptoms of PANS are reportedly exacerbated after Covid-19 infection. However, often, children are misdiagnosed by ADHD, autism spectrum disorder, or general anxiety disorder, resulting in urgently needed delays in care.
The dilemma of misdiagnosis
Unlike various other mental health conditions, Pans and Pandas tend to show up from the blue. Parents report sudden changes in their children’s behavior, including emotional instability, obsessed rituals, irrational fears and aggression. In Buckley’s case, these symptoms led to a gradual escalation of discipline in the school, and the disruption of the family was so severe that his three siblings were worried about him.
Like Buckley, many children have experienced years of misdiagnosis, labeling and abuse before making the right diagnosis. These delays can lead to progression of severity (from mild to moderate to severe), increase pain throughout the family and increase the risk of long-term neurological damage and the time it takes to heal.
Scientific treatment methods
Since pot/pandas are driven by immune dysfunction, effective treatments target inflammation and immune regulation. Front-line interventions include non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and antibiotics in the presence of active infection. For moderate to severe cases, the purified blood product IVIG containing the antibody may and should be used.
However, IVIG is not without obstacles. Treatment costs up to $150,000 per year and usually requires multiple infusions. This care is often inaccessible for families who have struggled with emotional and financial stress, especially in the absence of insurance coverage.
Public Policy Progress: Tennessee Leads
As of 2025, several states, including California, Massachusetts, and Virginia, require insurance for pot/panda treatment. Tennessee joined their ranks this year, after a tough legislative campaign led partly by families like Teng Teng.
Tennessee’s new policy states that the state’s Medicaid program must cover IVIG’s Panth and Panda children. For Barkley and others, it’s more than just a victory.
One parent, Lauren Wilson, testified in the Tennessee Senate about her daughter’s experience. Misdiagnosed, she deteriorated to the point where she was held in a mental illness and was hospitalized far from her hometown. It wasn’t until later that she was correctly diagnosed and began receiving IVIG infusions – after her family sold the house to pay for it. Such stories emphasize the urgency of expanding insurance coverage and clinical awareness.
Why is consciousness important
Delay in diagnosis of pot/pandas can lead to years of education, social withdrawal and trauma loss. However, when early recognition and appropriate treatment is received, recovery is not only possible, but may be possible. Barkley’s story is proof. His mother reported that his 90% better than 90% and returned to school after being directed by companions by companions of peers/pandas. Then, other doors start to open, eventually leading to a company that listens and takes action.
Call for action
We need more education from pediatricians, school staff and insurance companies. When a child suddenly experiences a sharp change in behavior, clinicians must consider Pans/Panda as part of the differential diagnosis. We also need more state tasks to ensure equitable access to treatments like IVIG.
I have seen the shift when science, policy and compassion are consistent. Let’s work together to bring this lifesaving knowledge to every family, every provider and every state. The bet is too high to do anything.
Photos: richvintage, Getty Images
As founder and CEO of Twelvestone Health Partners, Shane Reeves has established a top-notch professional infusion center organization covering 4 states and 23 locations. With patient experience data, including over 1,500 5-star ratings, twelve velvestones have become models of care delivery, focusing on people with chronic long-term illness.
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