Plasma Exchange is accepted as a 1st-line therapy, either alone or with other treatment for PANDAS, according to the Merck Manual and the American Society for Apheresis.
The full ASFA guidelines, as established in the 2013 Journal of Clinical Apheresis, appeared in their ‘Special Issue’ that is published every 3 years. The guidelines can be found at: Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue.
Merck Manual on Therapeutic Apheresis:
In related news, a recent case series of 35 youths, TPA (Therapeutic Plasma Apheresis) was found to “produce dramatic clinical benefits”. The same case series cited that “these cases clearly demonstrate that inclusion of TPA in a multi-faceted treatment approach has potential benefits for children and adolescents with severe symptoms of PANDAS”. Latimer et al. 2015.