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What exactly is the CamK showing?


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Hi Christianmom--Have you taken a look at Buster's notes on this? You can search on his name and "Cam" and read through his explanations--there may be info in the Helpful Threads post at the top of the Pandas forum(? not sure -- but worth checking.)

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You may have already found this... but Buster's PANDAS FAQ does contain some concise info about the Cunningham tests and CaM kinase II (check the section titled "Tests: Antineuronal Antibodies Tests"):

 

http://www.latitudes.org/forums/index.php?showtopic=6266

 

And here's a fascinating old thread started by Dr. T (when he was an active member of the forum) about the signficance of the Cunningham tests from his perspective. Buster weighs in toward the end of this thread (Post # 33):

 

http://www.latitudes.org/forums/index.php?showtopic=7228

 

Hope that helps!

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Worried Dad,

 

Thank you so much for the helpful links!

 

I copied this from Dr. T's post:

 

"This is what I find it most useful for:

 

Distinguishing non-immunological TS and/or OCD from PANDAS-like illnesses."

 

Does this mean that a high CamK (above 150?) is definitely linking the TS and/or OCD to an immunological cause (i.e. PANDAX condition). In other words, the TS and/or OCD in a child with high CamK has to have a infectious cause? Would it then be impossible for a child to have regular TS and/or OCD and have a high CamK? Their OCD must be caused by PANDAX? Is that the way you understand this? Or is it possible for a child with regular TS and/or OCD to get strep, not have PANDAS, but just have a high CamK because of having had several strep infections that weren't properly treated.

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Yeah, I'd interpret it the same way you did. High CaM K II indicates high probability of infectious cause. As I understand it, that's what Dr. C's research shows.

 

 

Worried Dad,

 

Thank you so much for the helpful links!

 

I copied this from Dr. T's post:

 

"This is what I find it most useful for:

 

Distinguishing non-immunological TS and/or OCD from PANDAS-like illnesses."

 

Does this mean that a high CamK (above 150?) is definitely linking the TS and/or OCD to an immunological cause (i.e. PANDAX condition). In other words, the TS and/or OCD in a child with high CamK has to have a infectious cause? Would it then be impossible for a child to have regular TS and/or OCD and have a high CamK? Their OCD must be caused by PANDAX? Is that the way you understand this? Or is it possible for a child with regular TS and/or OCD to get strep, not have PANDAS, but just have a high CamK because of having had several strep infections that weren't properly treated.

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WD! Thank you for that explanation--HOW have I missed that high Cam indicates infectious (most likely) causation--Good heavens, that says so much and explains the difference from "regular" OCD, etc. thank you!

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Well, okay, so if even "normal" kids get elevated Cam K during active strep, then I get the infection causation. But then what the heck infection??? Does elevated Cam K mean ACTIVE infection then?? Remind me again WHAT elevates Cam K??? The antibodies to STREP/illness, or the auto-antibodies?

 

And even "normal" kids will have some anti-neuronal antibodies, right?

 

So confused....again...

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I don't think 'normal' kids (no OCD, no tics) would have anti-neuronals out of range.

I believe it is a past/or present infection that has crossed the blood brain barrier and is causing a auto-immune disease/state, attacking the brain, and the overall score indicates how serious a problem that is-

I thought non-PANDAS kids who currently have strep would not test in PANDAS range...

Edited by S & S
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S&S--no , not in pandas range for normal strep kids, but still have CAm K elevated. So wonder how this really indicates the autoimmune disorder??

So the infection crossed the BBB or the auto-antibodies?

Sorry for the ???'s.

 

 

**

In the result packet, it is stated that a CamK score of 0-130 is where 'normal' (hate that word) will place, and a 'normal' child with active strep might place as high as 139.

Here is something I copied from the result paper:

"Our hypothesis is that antibody-mediated autoimmune

mechanisms as well as infection may contribute to the

pathogenesis of some movement and behavioral disorders. In

SC, group A streptococcal infections induce cross-reactive

antibodies that deposit in the basal ganglia and lead to CaM

kinase II activation in neuronal cells (Kirvan et al., 2003).

PANDAS sera were found to induce significantly higher

levels of CaM kinase II activation than sera from non-

PANDAS OCD, tic, and ADHD groups not associated with

streptococcal infection. In fact, PANDAS patients diagnosed

with isolated tics produced the highest level of CaM kinase II

activity similar to chorea. Although we do not know exactly

how disease producing IgG antibodies cross the blood–brain

barrier, we can suggest that infection or the antibody itself

may affect the blood–brain barrier. Recent work on behavior

and immunity demonstrated that LPS or epinephrine affected

the blood–brain barrier to allow IgG to penetrate the brain

(Huerta et al., 2006)."

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Sorry....what is LPS?? Isolated tics....does that mean "just tics" and no ocd?? Interesting...

 

My smarts have run out ;-) I don't know anymore.

We had a score of 175, and my daughter has heavy OCD, and no daily tics, just episodes that start with vocal tics, then move to 'tourette' in nature- the swearing/loss of control verbally, loss of control of her body, spitting, etc.

I was told in a PANDAS consult that our score was very high, one of the 5 highest he had seen, and it was no grey area- definitive PANDAS.

I forgot, have you done the test yet?

If you have, you can email your questions and maybe get the clearer answers you are looking for- but it still is really a 'research' test.

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LPS=Lipopolysaccharide? I just googled LPS and epinephrine and that seems to be what it stands for? But what is that? I don't know. Guess I'll google some more.

Ah, yes. from wikipedia:

Lipopolysaccharides (LPS), also known as lipoglycans, are large molecules consisting of a lipid and a polysaccharide joined by a covalent bond; they are found in the outer membrane of Gram-negative bacteria, act as endotoxins and elicit strong immune responses in animals.
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