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Hi, I am new to this forum and am hoping that someone out there maybe able to help us. My son had an abrupt onset of several tics last October we took him to the pediatrician and showed her a video, she ran a strep test that came back positive. She said she believed it to be PANDAS and sent us to a neurologist the next 6 months where complete ###### for him and us. His personality changed from a fun loving happy boy to self consiece child that was failing 1st grade and was scared to be alone and started having temper tantrums. He was confused most of the time and started having some OCD rituals. Finally after several courses of antibiotics the symptoms slowly started to diminesh. He had a recurrence of tics only with an ear infection and exposure to the flu. If the OCD symptoms where present they where minor and nothing like when he had strep. Over the summer he was mostly symptom free except a throat tic. He's been in school for a month now and this past Friday when I picked him up I saw an eye tic, that has continued. We took him to the pediatrician with a list of diagnostic test from the PANDASNETWORK.org site. She ran many of them. The results came back that he recently has not been exposed to anything but the allergy portion of the test came back high. She also said that the test did show that he has had microplasma P, mono and strep in the past, not sure how long ago. she also mentioned that his white blood cell count was fine and that other counts showed him immune system is working the way it should. My question is are allergies a trigger? And if so would his blood test came back with an elevated white blood cell count or wouldnt the immunty portion of the test have been elevated? Could this not be PANDAS related but anxiety? He is a perfectionist and does have anxiety. Thanks to anyone that can help. We live in Atlanta, the doctors here while they believe in PANDAS are not very helpful in diagnosing it. They have all told me that we will treat the symptoms as they pop up. This is FRUSTRATING!! We still are not sure that it's PANDAS. Meanwhile I'm scared of him getting sick or my daughter coming home with an illness.

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In our experience, yes, allergies can trigger a PANDAS/PANs response; they can also trigger increased anxiety because they tend to drive histamine production which, as a neurotransmitter, can contribute to increased anxiety levels in prone individuals.

 

I think most of us on this PANDAS path would tend to feel that anything that can trigger an immune response . . . and allergies ARE an immune response (a hyper-immune response, actually). . . is related to PANDAS/PANS, and you may see an increase in PANDAS/PANS behaviors as a result of that immune system getting "poked" as it were by exposure to allergens.

 

My DS15 has PANDAS, which similar to you, we got under control with abx. But he still experiences behavioral flares with exposure to strep, viruses and allergens; he's always been reactive to pollen and mold seasonally. He's also, similar to your son, perfectionistic and prone to anxious responses at times, so I can see where you would question whether this is PANDAS/PANs related or "just anxiety." In our case, I think we contend with both: my DS is naturally prone to some anxiety, and his immune response to triggers can exacerbate the anxiety. A full-blown PANDAS episode (strep-related, in our case), meanwhile, does more than merely exacerbate his anxiety level -- it drives him out of the galaxy and into a whole 'nother world.

 

So when allergies or other triggers contribute to a higher-than-typical anxiety level, we combat the increased histamine levels with quercitin, Pepcid and, if necessary, Zyrtec. If all your DS's other testing lies in the normal range, you might try something specifically aimed at the allergies and see if that helps tame the tic.

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We discovered that allergies are a huge trigger for my son. Dr. M suspected this and referred us to an allergist. After allergy testing I was quite shocked that he is highly allergic to too many things to list and the level of the allergy is alarming. Allergy treatment is providing a relief in some of my DS PANS symptoms as well as eliminating rashes and angioedema that started after he was DX with PANDAS/PANS. He takes OTC Zyrtec and Flonase. I am happy with the results but am thinking of adding the Pepcid as well as quercitin as Momwithocdson has stated. Allergy testing will also help you with avoiding exposure to those things that are avoidable as much as you can. My DS is allergic to all trees and grasses, so that it hard! We found that he is so allergic to dust mites that when he was tested the doc said she had never seen a reaction so big- this needed to be dealt with in a huge way in our home. So yes, I really encourage you to have the testing done!

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Allergies definitely have an impact per DrT. Both my kids are now on Immunotherapy, allergy shots, due to severe allergies. Big difference. The last month no shots due to doc & our issues, both kids are struggling & have strep again. Major sinus problems. Also my son was taken off of Singulair by Dr M, she says it increases the Ocd.

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Hi! I'm also in the Atlanta area. At least you've found some PANDAS friendly doctors (to a certain degree that is). We are traveling to CT to see Dr. B. He is fantastic and it is WORTH the travel, expense, etc. Allergies are a HUGE component of my DD PANDAS issues. Spring and Fall are the absolute worse times for her due to this. In the past, her allergies would cause continual infection and it was a never ending cycle. She is getting so much better now with the help of Dr. B. she takes Singulair and Veramyst, in addition to Augmentin daily. Makes a huge difference (but still contracted Step and Mycoplasma while on it!). She is now on her third IVIG. IVIG has been the key to resetting her immune system. Also, since you live in Atlanta, there is an EXCELLENT CBT/ERP psychologist here. She helped (and continues to help) my daughter SO much. PM me for more info. There are others in Georgia with PANDAS. You are not alone.

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