Cases 3 (PPM1D), 9 (SYNGAP1), 13 and 14 (NLRC4), 15 and 16 (RAG1), 19 and 20 (SHANK3), and 21 (CHK2) also had preexisting ASD or developmental delay prior to developing PANS. Here, SYNGAP1 is linked to Global developmental delay.