Help interpreting Western Blot results

[bjberglund]

My 10 y/o son was diagnosed with Pandas in May. His symptoms have greatly improved with antibiotic treatment. We recently tested for Lyme (no symptoms yet) and received his results yesterday. I don't talk with his Dr until next week so I was wondering if anyone can give me a heads up as to what the results mean and what sort of treatment I can expect?

 

IgM results

**23-25 kDa = Ind

**31 kDa = ++

**34 kDa= Ind

**39 kDa= Ind

**41 kDa=+

**83-93 kDa= +

 

All non-double starred bands were negative.

 

IgG results

**41 kDa=+

 

All other bands were negative.

 

As I think back over the sequence of events, I'm wondering if he could have had Lyme/Strep at the same time. He was in a wooded area the day before Thanksgiving 2012. The next day (Thursday) he got sick...said his whole body ached, hard to walk, stomach ache, headache, etc. He was diagnosed with strep on Saturday. If he had been bitten by a tick would the symptoms have hit him overnight or does it take some time? He missed a week of school but after a round of zithromax he was fine. He wasn't diagnosed with Pandas until May. If he had Lyme could that have suppressed/messed up his immune system so that the strep then caused Pandas? I realize I may be stretching for an explanation here but I'm trying to make sense of everything.

 

I don't remember any other time in which he was bitten by a tick or had a rash.

 

Thanks for your help!

[pr40]

if I understand it correctly, your results point to a recent infection.

-- If he had been bitten by a tick would the symptoms have hit him overnight or does it take some time?

both. some overtime which are flue like and others overtime that are more like PANDAS symptoms and also include fatigue, joint pain etc.

 

If he had Lyme could that have suppressed/messed up his immune system so that the strep then caused Pandas?

-- PANDAS is a set of symptoms that are caused by bacterial infections. Lyme is also caused by bacterial infections. PANDAS names psychatric symptoms, Lyme includes those but has others. Both call for a different way of thinking other than one cause. Actually, the "cause" of both conditions is an auto-immune reaction. "Cure" involves helping body change the way it reacts to the bacteria which includes killing of that bacteria with abx and so on.

In short, both Lyme and PANDAS are conditions that describe a state of the organism.

[Hopeny]

Sorry this is brief, I will post more later but 31 takes one or two years to show up so there us previous exposure. 83-93 is the DNA of the Bb spirochete. 23 is Bb specific. This test would be a flaming positive along with symptoms in the Lyme community. My DD never had strep until she got Lyme, untreated it wrecks the immune system. Kids get sick but then it goes stealth. My older Dd was never in the woods even , she got it in a backyard. Never saw a tick, never had a bullseye. My younger one also got it from a backyard, has a bullseye but has taken months if treatment and still not gone. Best if you have signs to start treating ASAP. I have a post on the western blot you can search in that has some additional information and others views. It has taken a long time but my older DD is almost fully recovered. Where are you located?

[sf_mom]

Is it possibly he was bit previously? A healthy immune system can keep Lyme in check for a long time. Things like surgery, vaccinations, other bacterial infections of strep, mycoplasma, chlamydia pneumonia, can trigger the cascade of symptoms both physical and/or psychiatric.

 

Your sons results show a response to some Lyme specific bands. Our LLMD would treat based on those results and PANs presentation.

[msimon3]

Lyme can cause neuropsychiatric symptoms often associated with PANDAS/PANS. It is doubtful that the symptoms could arise in one day as you mentioned, but instead is much more likely that an infection occurred earlier than Thanksgiving 2012 and went unnoticed.

 

You should talk to a LLMD about your bands. If we are looking at Igenex results, IND means not strong enough to be positive, while +/++/+++ are increasing measures of positive results. Bands with ** are considered significant by Igenex based on their studies. See http://www.igenex.com/labtest.htm

 

These bands are proteins that are sifted by weight, stuck on to a paper blot, and your antibodies either stick to them or they don't. If they stick, and can be seen in enough quantities, then a positive result is scored. Antibodies to other antigens may unintentionally stick to these Borrelia proteins, or some of these proteins may be expressed by non-Borrelia organism, which can cause false positives due to cross-reactivity. http://en.wikipedia.org/wiki/Western_blot

 

Band 31 is outer surface protein A (ospA, Borrelia, little cross-reactivity)

Band 41 is flagellate protein (not specific to Borrelia, very cross-reactive)

Band 83 is an extracellular protein (Borrelia, some cross-reactivity)

 

Here is a nice write up from an LLMD in Maryland on the subject:

http://lymemd.blogspot.com/2009/02/understanding-western-blot.html

[bjberglund]

Thanks to everyone for your responses. Hopeny, we lived in Michigan most of my son's life until last summer when we moved to Minnesota. We have a woods/pond in our backyard here and the tick population in the area is pretty high. It does make more sense that he was exposed prior to the pandas symptoms started but he too never had a rash, bullseye or tick that I know of.

 

What treatment do you think is best? In the last 2 months he's done a round of zith and a round of penicillin for the pandas as well as a round of flagyl for clostridia. I hate the thought of more abx.

 

Thanks again!

[Hopeny]

I hate to tell you this buy my DD has been on combo abx for over a year. We are just now approaching taking her off, I think she is about as symptom free as she is going to get. It just takes forever with Lyme. The bacterium that causes Lyme is extremely "smart" and stealth. We used abx, supplements and herbal antibiotics and have a team of doctors along with CBT that tapered off of in June. Tens of thousands of dollars, massive debts. Prior to all of this she was a "normal, happy kid". I was not the type of mom that would go off the radar as I have with doctors, previously before Lyme I only went to the "top doctors" affiliated with top hospitals - I felt absolutely betrayed when their recommendation was to put my daughter on psych meds and give her pain meds at the ripe age of 8. While I watched her helplessly deteriorate, considering hospitalizing her, I took to the internet and thankfully was able to find help. BTW there is a fine line between Lyme and PANDAS symptoms, recently the term PANS has come to encompass strep, Lyme and other infections. The other issue with ticks is the nasty co-infections they carry. We treated for Ehrlicia, Rocky Mountain Spotted Fever, Anaplasmosis, and Mycoplasma which all came up +. We also treated for Bartonella even though she tested negative she had many symptoms and it is difficult to test for. We have used Doxy, Amox, Biaxin, Augmentin, Zith and Rifampin. All have had various positive effects. There is no one formula, just things that seem to work. Each case is different. My belief is that with children because they heal, if you treat aggressively you have a better chance for a more thorough recovery. My advice since you are fortunate in that the bloodwork actually shows evidence of Lyme, would be to get on aggressive course of both antibiotic and supplement treatment with a knowledgeable Lyme M.D. as soon as possible. Lyme can cause literally hundreds of symptoms and it is best to work with someone really experienced who knows what they are doing. It has not been easy by any means and we are all deeply changed. . For some people, they get better for Lyme and do not have to go what we have been through. Others do not. It is a lot to think about and can be very overwhelming.

Thanks to everyone for your responses. Hopeny, we lived in Michigan most of my son's life until last summer when we moved to Minnesota. We have a woods/pond in our backyard here and the tick population in the area is pretty high. It does make more sense that he was exposed prior to the pandas symptoms started but he too never had a rash, bullseye or tick that I know of.

 

What treatment do you think is best? In the last 2 months he's done a round of zith and a round of penicillin for the pandas as well as a round of flagyl for clostridia. I hate the thought of more abx.

 

Thanks again!

[Dedee]

You should see an LLMD for treatment options. Your average physician and even a good PANS physician will not know the best treatment for lyme and co infections. You need a lyme doctor.

 

Dedee

[bjberglund]

Thanks, Dedee. I have an appt with a naturopath dr on Friday that specializes in treating lyme.