First offering · PANS / PANDAS education

Understanding abrupt-onset neuropsychiatric symptom patterns.

PANS and PANDAS are the first clinical pathway on RubyHealth — not the whole product. They are clinical diagnoses centred on an abrupt change in specific neuropsychiatric symptoms. RubyHealth helps organise caregiver observations and biometric context for qualified clinical review.

PANS and PANDAS symptom wheel infographic

What is PANS / PANDAS?

PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, requires an abrupt onset of obsessive-compulsive symptoms or severely restricted food intake, together with abrupt symptoms from at least two additional clinical categories. Other medical and psychiatric explanations must be considered because PANS is a diagnosis of exclusion.

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a proposed subgroup involving childhood-onset OCD or tics with an episodic course and a temporal relationship to Group A streptococcal infection. The mechanisms, biomarkers, and best treatment approaches remain areas of active research and clinical debate.

Why early context matters.

Families may report changes around infections, stressors, sleep disruption, medication changes, or environmental changes. Recording timing and context can help a clinician assess competing explanations; an association in a log does not establish a cause.

RubyHealth focuses on structured context: biometric trends, symptom notes, medication changes, sleep disruption, diet, activity, and parent observations over time.

How are PANS / PANDAS and autism related?

Autism is a distinct, lifelong neurodevelopmental condition. It is not caused by PANS or PANDAS, and autism does not by itself establish either diagnosis. A person can be autistic and also be evaluated for an abrupt-onset syndrome; current studies describe co-occurrence but do not prove that one condition causes the other.

The clinically useful question is whether a change is genuinely new and abrupt compared with that person's own developmental baseline. Longstanding sensory, communication, eating, repetitive-behaviour, sleep, or anxiety differences should not be relabelled as a flare solely because they overlap with a symptom list.

What RubyHealth can record.

Condition profiles are stored separately so autism and PANS/PANDAS can coexist without being conflated. Episode check-ins can record onset speed, prominent OCD/eating/tic changes, 0–4 caregiver ratings, functional impact, symptom domains, context, and urgent safety concerns.

Analytics summarise event counts, completion, severity, impact, and trends against the person's own record. They are observational—not a diagnostic scale, causal analysis, emergency triage system, or treatment recommendation.

Why monitor biometrics?

Heart rate, HRV, sleep, activity, and temperature can change for many reasons, including infection, stress, exertion, medication, device fit, and sleep disruption. RubyHealth tracks these signals against the person's own available baseline as context for review.

The exploratory pattern view looks for combinations of shifts, such as lower HRV, higher resting heart rate, disrupted sleep, temperature changes, and caregiver-observed context. These rules have not been validated to predict or diagnose a PANS/PANDAS flare, and a single abnormal reading is never treated as one.

View supported devices

HRV

A sustained change from personal baseline is nonspecific and can provide autonomic context for review.

Resting Heart Rate

Elevation above baseline can appear during infection, stress, heat, or exertion.

Sleep

Total sleep, deep sleep, REM sleep, and night waking help show changes in recovery and regulation.

Temperature

Temperature shifts are reviewed as context, not as standalone diagnosis.