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Pandas results finally in


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Hey Everyone,

 

Ok. I was finally able to get the results from the blood work. But now I am confused.

 

The D-nase came back negative, but the Anti-strep came back positive. The pediatrician didn't know what to do. I don't know what to do. I asked her if Tyler needs a round of antibiotics and she didn't think so. Does he???

 

Loren

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Hi loren,

When you say D-nase is negative, not sure what that means. Like ours was a low number, it stated < 50.

And the ASO was 174, (less than 200 considered in range, not an issue). Whatever number you have may just indicate strep was present in last couple months. I think its normal for it to be elevated a little in school age children, but not too much. The expected range is usually listed on the lab report.

 

If your doc does not know, than she needs to consult with someone else. She must know someone--I believe an infectious disease doctor would be familiar. Or you'll have to consult with someone in another state via telephone. If she doesn't, then you have to make some calls. If need be, I'll give you the name of the doc that did our test and you could call for advice. How is your child currently doing?

 

Faith

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Hi Loren,

 

What were the numbers for the tests? Did she say? I had to call my Ped. to get the # because he just left a message saying negative.

 

C.P.

 

HI C.P.

 

She is going to mail them to me.

I just went to the link that helps explain the tests, but now I'm more confused than ever!

Do you know anything about them?

 

Loren

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Hi loren,

When you say D-nase is negative, not sure what that means. Like ours was a low number, it stated < 50.

And the ASO was 174, (less than 200 considered in range, not an issue). Whatever number you have may just indicate strep was present in last couple months. I think its normal for it to be elevated a little in school age children, but not too much. The expected range is usually listed on the lab report.

 

If your doc does not know, than she needs to consult with someone else. She must know someone--I believe an infectious disease doctor would be familiar. Or you'll have to consult with someone in another state via telephone. If she doesn't, then you have to make some calls. If need be, I'll give you the name of the doc that did our test and you could call for advice. How is your child currently doing?

 

Faith

 

Faith,

 

She just said that the D-nase was negative but the Anti-strep was positive. She didn't talk at all about the numbers and I didn't even know to ask her. She said that a lot of children's Anti-strep come back meaning they have had a strep infection but that it doesn't mean anything really important. And she said she didn't think he needs an antibiotic (when I asked). She did recommend that I go to Childrens Hospital of Phila but it takes many months to get an appointment there.

 

All in all, Tyler is doing well. He tics, but they are not off the wall like they were in the beginning (jeez, a whole few weeks ago, it feels like forever!!).

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hopefully Ronna or Alison will stop by and share what the results mean, as they are our 2 moms who have a LOT of experience with PANDAS kids

 

once you have the actual figures, it would be very helpful if you could post them here as a reference source

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Loren,

 

I don't know too much about PANDAS, but I'm very interested. All I know about the tests are the ASO titer rises 3 to 6 weeks after a strep infection. The AntiDNASe-B titer rises after 6 to 8 weeks after a strep infection. I believe if one is high the child has had strep sometime in the past few months. The body is producing antibodies to fight off the strep. (I mostly understand things in laymens terms, so I hope that helps a little until someone with more knowledge pops in)

 

I remember the first ped. we saw did not test my son for PANDAS because he knew my husband had TS as a child. He also told me he could walk into any school and 1/2 the kids would test positive for strep. (I don't know what that means.) When I demanded the test be done it was a year after the explosion. I have no idea if my son ever had strep. His titers were very low. 6 for one and less then 60 for the other. I'm mostly curious because how much PANDAS and TS are alike.

 

Thanks for sharing your info when you get them.

C.P.

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We recommend evaluation of all children who present with the sudden onset or exacerbation of obsessive–compulsive symptoms, using the approach summarized in Fig. 1. This diagnostic algorithm, which is based on the literature summarized earlier as well as our clinical judgement, begins with a history-taking, mental status examination and focused physical examination. Initial investigations in children with a history suggestive of streptococcal infection or a strong family history of rheumatic fever, or both, should include throat cultures and antistreptolysin O titres. These titres should be repeated after an interval of approximately 3–4 weeks, because a correlation of symptom severity with changes in antibody levels is far more informative than an isolated antistreptolysin O titre. We recommend antistreptolysin O titre, because the other antistreptococcal test reported in the PANDAS literature, namely, antideoxyribonuclease-B (antiDNAse , is expensive and not widely available in Canada.

 

I feel a bit like a broken record. Overall, a single ASO titer will not give you enough information to diagnose or rule out a PANDAS dx. The "trend" in the ASO titer is what is helpful...is the antibodies rising or declining. If your doctor does not know how to interpret the results then he/she needs to speak with someone knowledgeable. The NIMH is very willing to consult with doctors.

 

This is a good article...

 

http://www.cmaj.ca/cgi/content/full/165/10/1353

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