Following the Clues: How Dr. Yujuan (Julia) Zhang Brings Hope to Families Facing PANS/PANDAS

When you’re a parent watching your child change overnight, gripped by tics, anxiety, rage, or rituals that seem to come from nowhere, you’re desperate for answers. You want someone who doesn’t just see your child as a mystery, but as a whole person. Someone who connects the dots. Someone who believes you.

For many families, that someone is Dr. Yujuan (Julia) Zhang.

She didn’t set out to become a voice for children with PANS and PANDAS. But while training in pediatric rheumatology at Stanford, she began seeing cases that couldn’t be ignored, children with sudden, severe neuropsychiatric symptoms who responded not to psychiatric medications, but to anti-inflammatory treatments. Her mentor, Dr. Jennifer Frankovich, was one of the early leaders in this field. And what Dr. Zhang saw in those early days stuck with her.

“Witnessing so many amazing cases, I was able to recognize the link between an infectious event and a sudden onset of neuropsychiatric presentation quite early in my fellowship training,” she recalls.

She followed the science. But more than that, she followed the children and the families who were often left searching in the dark.

Now practicing at Tufts Medical Center, Dr. Zhang brings a rheumatologist’s lens to these complex cases. And that perspective matters more than most people realize.

“A rheumatologist is always trying to identify and treat inflammation,” she explains. “In my eyes, children with PANS/PANDAS suffer from neuroinflammation triggered by infectious or even non-infectious events.”

Where others may focus solely on the behavioral or psychiatric symptoms, Dr. Zhang sees something deeper - an immune system misfiring, a nervous system inflamed, a brain under siege.

And she’s not afraid to treat it.

It Takes a Team

Dr. Zhang is not first to say this work can’t be done alone. PANS/PANDAS doesn’t fit neatly in one medical box. It lives somewhere between immunology, psychiatry, infectious disease, and neurology. And that’s why collaboration is key.

“Multidisciplinary collaboration is critical, especially in moderate to severe cases,” she says. “We often work with infectious disease, psychiatry, and neurology teams.”

One child might need psychiatric stabilization before they can begin immune-based therapies. Another might respond dramatically once an infection is identified and treated. And still others may need a thorough neurological workup to rule out other conditions.

That complexity can be daunting. But to Dr. Zhang, it’s a puzzle worth solving.

A System That Needs to Catch Up

Despite her success treating children with anti-inflammatory and immune-modulating therapies, Dr. Zhang knows that much of the medical world still needs convincing. The lack of research, the skepticism, the waitlists, it’s a frustrating reality for many families.

“We need well-designed trials to show that antibiotics and anti-inflammatory treatment are more effective than placebo,” she says. “That would help more medical professionals get on the same page, to recognize that these patients need medical and neuropsychiatric care.”

She’s also hopeful that future research will clarify the why - the exact mechanisms behind PANS/PANDAS - and lead to more effective, safer, and more accessible treatment options.

A Message to Families

For families in the thick of it, Dr. Zhang offers something even more powerful than expertise: validation.

She sees your child. She believes the connection. And she’s not afraid to treat what others might overlook.

“When there is no clear infectious trigger identified,” she says, “I at least try to consider an anti-inflammatory approach - to minimize inflammation and therefore minimize damage.”

In a world where families often feel dismissed or gaslit, Dr. Zhang’s approach is a breath of fresh air. It’s rooted in science, yes - but also in empathy.

Her story is one of following the evidence, listening to families, and building bridges between specialties. And for the children and parents who’ve felt lost in the system, that kind of doctor can change everything.

If you’re navigating PANS or PANDAS, know this: you’re not alone. There are doctors out there like Dr. Julia Zhang who are listening, learning, and fighting for better answers - one patient at a time.