{
  "abstract": "This report describes a child diagnosed with a presentation consistent with paediatric acute-onset neuropsychiatric syndrome (PANS), accompanied by obsessive-compulsive symptoms and trichotillomania. A school-aged girl in middle childhood developed sudden-onset washing rituals, contamination fears, hair-pulling behaviour and progressive academic decline shortly after a severe throat infection. Her symptoms included prolonged handwashing, repetitive utensil cleaning and recurrent hair pulling resulting in a patch of incomplete alopecia. Psychiatric assessment confirmed moderate obsessive-compulsive symptom severity, and dermatological evaluation supported a behavioural origin of hair loss consistent with trichotillomania. Comprehensive investigations including blood tests, neuroimaging, electroencephalography, abdominal ultrasound and cognitive testing were unremarkable except for elevated anti-streptolysin O (ASO) titres, indicating a past streptococcal illness. She was treated with fluoxetine, behavioural therapy and family psychoeducation, leading to a gradual reduction in compulsive behaviours, decreased hair pulling, improved daily functioning and early hair regrowth over 3 months.",
  "authors": [
    {
      "affiliations": [
        "Psychiatry, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India"
      ],
      "name": "Christopher Peter"
    },
    {
      "affiliations": [
        "Dermatology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India"
      ],
      "name": "Mayuresh Shamsunder Pavaskar"
    },
    {
      "affiliations": [
        "Psychiatry, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India"
      ],
      "name": "Akanksha Sharma"
    },
    {
      "affiliations": [
        "Psychiatry, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India"
      ],
      "name": "Abdul Qadir Jilani"
    }
  ],
  "title": "Paediatric acute-onset neuropsychiatric syndrome (PANS) with trichotillomania",
  "uid": "e7e0ae36-0f00-5114-8dd7-4e9d1bc7a201"
}