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Simply this is a 2 carbon shifting mechanism

Although the current diagnosis would indicate people affected with PANS/PANDAS are children, adults have also been given this diagnosis, sometimes due to persistent symptoms following developing the condition as a child and other times due to developing the symptoms in adulthood

Spitzer et al

10, e2303473

doi: 10.3389/fimmu.2026.1753434 Received 24 November 2025 Revised 03 March 2026 Accepted 10 March 2026 Published 25 March 2026 Volume 17 - 2026 Edited by Jiaxiong Tan, Tianjin Medical University Cancer Institute and Hospital, China Reviewed by Ye Zhitao, Guangzhou Medical University, China Peng Ouyang, The First Affiliated Hospital of Jinan University, China Updates Copyright 2026 Li, Wang, Xu, Huang, Hong, Ji and Liu