PANDAS and : Scarlatiniform rashes and petechias

[PANDAS_Denmark]

Every time my 6 year old "PANDASchild" gets an strep-infection he gets a scarlatiniform rash and petechias as well.

 

Has anyone else experienced this connection between strep-infections, PANDAS and scarlatiniform rashes and petechias ???

 

And/or do any of you have a possible explanation ??

 

I know that scarlatiniform rashes can be caused by streptococcus - but petechias ?

 

I have talked to several doctors about this, but gets no answers :-(

 

Yours sincerely -

PANDAS_Denmark

[kim]

Hi Pandas Denmark/All,

 

When you posted this, I knew I remembered something about petechiae.

 

It has always bugged me, that I couldn't get any answer to why both of my boys had elevated MPV in blood work. MPV=mean platelet volume. This was reg. Ped who ordered blood work. He didn't even know what MPV stood for (I'm NOT joking) so I doubt that he realized that this was eleveated in both boys. It is literally a measurement of the size of the platelets. The "newer" the platelets, the larger they will be. So presumeably, my boys had "newer" platelets. This would suggest that they were making new platelets for some reason. Their platelet levels were normal. Now my understanding is, that there may be another autoimmune issue here, although since it would only set off red flags, if it was coupled with an abnormal platelet level, I doubt that anyyone would find it very significant. (unless you were specifically looking for autoimmune issues) If you get a chance, read these articles. Maybe we can discuss it a little more, if anyone else has an interest in this subject.

 

 

 

http://www.nhlbi.nih.gov/health/dci/Diseas...ITP_WhatIs.html

These dots, often seen on the lower legs, are called petechiae (peh-TEE-kee-ay). Petechiae may look like a rash.

 

In most cases, the body’s immune system is thought to cause ITP. Normally your immune system helps your body fight off infections and diseases, but if you have ITP, your immune system attacks and destroys its own platelets—for an unknown reason.

 

 

http://www.emedicine.com/med/topic987.htm

 

Pathophysiology: Platelet disorders lead to defects in primary hemostasis and have signs and symptoms different from coagulation factor deficiencies (disorders of secondary hemostasis). The body's reaction to vessel wall injury is rapid adhesion of platelet subendothelium. The initial hemostatic plug, composed primarily of platelets, is stabilized further by a fibrin mesh generated in secondary hemostasis. The arrest of bleeding in a superficial wound, such as the bleeding time wound, almost exclusively results from the primary hemostatic plug.

Hence, primary hemostatic disorders are characterized by prolonged bleeding time, and the characteristic physical examination findings are petechiae and purpura. In comparison, defects in secondary hemostasis exhibit delayed deep bleeding (eg, muscles and joints) and the characteristic physical examination finding is hemarthrosis. Hemarthrosis and muscle hematomas are not present in primary hemostatic disorders.

Autoimmune thrombocytopenias

Immune thrombocytopenic purpura

Immune thrombocytopenic purpura (ITP) is one of the most common autoimmune disorders. It occurs in 2 distinct clinical types, an acute self-limiting form observed almost exclusively in children (5 cases per 100,000 persons), and a chronic form, observed mostly in adults (3-5 cases per 100,000 persons) and rarely in children.

This disease is caused by autoantibodies to platelets. The antigenic target in most patients appears to be the platelet glycoprotein IIb/IIIa complex. Platelets with antibodies on their surface are trapped in the spleen, where they are efficiently removed by splenic macrophages. The mechanism of origin of these antibodies is not known. These antibodies may be directed towards the viral antigens and then cross-react with platelet antigens. They persist because of the failure of immune surveillance mechanisms to repress these antibodies. These antibodies can also react with the developing megakaryocytes in bone marrow, leading to decreased protection of platelets (ineffective thrombopoiesis

[faith]

Kim,

I'm still reeling from all the info re the vaccines, but this is catching my eye too, but think I need an assistant to explain it all.

 

But your mentioning of the MPV is what interests me ..... on my son's blood chem panel done last year by DAN doc, that was high on the MCV (mean CORPUSCLE volume). (thought we were having this in commone, but realize mine was MCV. Do you think this is significant in any way like you were talking about? It said 90.0 in the high range (ref range was 74.0 - 89.0), MPV was 10.1 in range, and Platelet 352 in range. The doctor never pointed that out either, but I have a copy of the test, so was just looking at it. Other things a little high was AutoMono# and Mono%. Have no idea what that is, but curious if you had that too. Don't know if any of this is significant, but figured I'd throw my potatoes into the pot!

 

I am going to make an appointment soon and ask to have some things redone since its been a year, I think he said he would do that last time we saw him.

 

Faith

[Mustang Carole]

Hi,

Please describe rash in more detail...example

raised, flat, with or with our pustules, areas affected first...

spreading , and with or without other symtoms and describe

ex. temperature, sore throat, aches, joint pain, etc and etc.

post other infections ongoing....

 

This will help other parents who do not understand the medical

teminology and better to have more info.

 

Thanks!

Carole

[kim]

Faith,

 

I can't remember if it's in the article that's posted or another one, that in some cases the body will attack it's own platelets. I think it said, that a low platelet count was not always a finding. It is an autoimmune reaction. I'm wondering if this could account for the "new platelets," and hence high MPV. My oldest sons was 12.2? I'm not looking at the results right now but it's 12 something. edit Oldest 12.4 youngest 10.9 ref range 6.5-10.5. I can't remember if either had been sick near the time this was done.

 

I guess if platelets are normal, they are keeping up with production, but.......

 

I just wish we had someone with some medical knowledge here. Maybe they would say that this is not unusual in younger people? I know these reference ranges can differ for kids. Maybe repeat testing with high #'s would make it significant?

 

Back to Panda Mom, I guess I was thinking, if her child gets petechias with every strep infection, couldn't this suggest that the platelets are being attacked?

 

Faith, I think the MCV has more to do with hemme/iron?

 

I have a note on copy that says autoimmune, candida and B12 (these are my notes from trying to find info long ago) but I'm not sure if it's written by MPV or MCV

 

Have you found anything on MCV?

 

Mustange Carole......any ideas?

[kim]

Great post regarding heparin/hepran sulfate and Petechiae/purpura

 

http://onibasu.com/archives/am/140593.html

 

 

 

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