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concerned mom

questions about lab results

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My DS had a blood test last week. Due to his overwhelming needle phobia, this was just his 3rd blood test since he was first diagnosed with Pandas in September 2010. There are two abnormal findings. The first was his ASO continues to be high. It has decreased since his last test over a year ago, but it is still above normal at 224 with the lab reference range of <150. His first test was 336 in 9/10, then by 12/10 it had dropped to 285 and now down to 224. So we’re moving in the right direction. Is it possible that 224 is actually relatively normal for DS, or is it a suggestion that his antibodies are still raging?

 

The other test that was high was his lymphocytes. They were 42.3 and the normal range is 25 to 33.3. I have read some abstracts of research which suggest that there is a correlation of high lymphocytes and PANDAS and Tourettes, but I’m still trying to wade through the technical information. I asked ds’s pediatrician if she thought the lymphocyte result was a sign of an autoimmune process or inflammation that could be making the brain blood barrier more vulnerable to antibody pass through, but she didn’t think much of the result and told me not to worry. We will be seeing DS's neurologist in a few weeks and I’ll raise the issue with her. She has been the one treating the PANDAS not DS’s pediatrician. My question to you is whether you have seen similar results with your PANDAS kids.

 

Thanks for any input you can offer. Symptomatically DS is doing fairly well now. I just see a few tics once in awhile and we can live with those. They are a little worse right now than they have been, but I suspect that is because there is strep and other illnesses going around his school. At least we're not seeing the emotional lability, separation anxiety etc. that we see with a major flare.

 

Any imput would be appreciated.

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The first was his ASO continues to be high. It has decreased since his last test over a year ago, but it is still above normal at 224 with the lab reference range of <150. His first test was 336 in 9/10, then by 12/10 it had dropped to 285 and now down to 224. So we’re moving in the right direction. Is it possible that 224 is actually relatively normal for DS, or is it a suggestion that his antibodies are still raging?

 

Yes, it could be quite normal for your DS to have a 224 for the ASO. The fall of antibodies is not well studied. There is a correlation seen in many patients of the rise of ASO within 0-4 weeks of an infection; however, the fall rate is not well studied.

 

In one study, 5% of kids (in the 5-10 age group) with no symptoms or preconditions had an ASO level > 196.

 

You might find this thread interesting: http://www.latitudes.org/forums/index.php?showtopic=3756&st=0&p=25312entry25312

 

Bottom line if you are not seeing symptoms, I wouldn't worry too much about the ASO rate as it really isn't an indicator of anything at this point.

 

The other test that was high was his lymphocytes. They were 42.3 and the normal range is 25 to 33.3.

Increased lymphocytes means that the T-cells are activated. They're working on something, could be sort of anything. Hard to say what else is going on. The good news is your kid's immune system is working. What it's working on isn't known. My personal advice is to treat this as a baseline and when/if you have a strong behavioral change take another look at the blood work. Sounds like you've got a decent doc.

 

Buster

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I've heard that high lymphocytes and low neutrophils = recent viral infection

low lymphocytes and high neutrophils = recent bacterial infection

Don't know if this is true or not.

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