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Apperance and PANDAS


Alex
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My son had Plasma Exchange 8 weeks ago and was doing great until he had a tooth infection go undiagnosed for at least a week. Before the tooth was discoverd infected and pulled his PANDAS symptoms were flaring back up. After the tooth was pulled he remained on an antibioitc for several days and had a fantastic day the last day of the antibiotic but started to have PANDAS symptoms flare back up as time went on. In conjunction he started to look worse and worse. He had dark circles under his eyes and a pallor to his skin.

 

We brought him to the Pediatrician on a Friday because I was convinced he had a sinus infection. The ped didn't think so but thought allergies instead. The next day my son had no energy, looked terrible and had a headache and his PANDAS symtoms were awful. We called the Ped's office which was closed but convinced the on call to give us an antibiotic. He has been on Omnicef for 10 days and his PANDAS symptoms have gone way down but my son is still not back to where he was at his best after the PEX. He looks a lot better too, but still with a little bit of dark circles

 

Now I am wondering if the dark circles and pallor were really just a result of the antibody attack on his system from the PANDAS coming back and that the ped was correct that there was no sinus infection. We are worried about what is going to happen after the full stregth omnicef ends and he goes back to prophylactic dose of azith.

 

Anybody else see this type of appearance just from PANDAS?

 

Alex

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Hi Alex:

 

Yes, I always notice this about my son, who is about 6 weeks post his first IVIG. He is so pale and has such dark circles under his eyes. He does not look as bad as he did pre-IVIG. My son did have low iron and low vitamin D when we drew his blood pre-IVIG. I have read that low iron can cause symptoms of ADHD as well as the pale color and dark circles. Allergies can also cause the dark circles.

 

I will be interested to hear what others have to say...

 

Elizabeth

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Yes. My son looked like a zombie with those dark circles. I noticed they were there, but when I got his 5 yr pics back, it was so bad. I was so mad at myself that this child looked so sick and I didn't see it even more. At the time of the pic, he was in a PANDAS episode but we didn't even know he had an active strep infection yet.

 

As for color of skin...my son is so light colored to begin with. He would be the most fair boy you'd probably ever see.

 

I keep meaning to somehow post his pic of what he looked like during his first PANDAS episode before we knew what we were facing. Haven't done that yet. My scanner isn't working right.

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Yes during exacerbation dd has pale skin and dark circles. Combine that with refusal to brush hair, and only willing to wear old non matching too small outfits, well you get the picture...

 

I am sorry this is happening post pex- this is devastating. Was he/she on abx?

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I am so sorry you have been through so much. The dark circles and pale skin were definitely there when my son was sick. When you looke back at his school picture compared to this year it is really impressive. My hope is that given the stress of the infected tooth the symptoms flared and hopefully things will improve. My other son had a pneumonia (we still don't know if it was H1N1 or bacterial) and I could see my son Carter that had plasma exchange start to flare a little. I saw some tics show up and some emotional/anger moments like before. I am pushing sleep and rest and trying to see if we can make it all go away. He seems a little better but it makes me also wonder if he has had a strep exposure that I don't know. We just sent our 3 month bloodwork out last week to Cunningham which was drawn in the middle of all this so we shall see. Latimer said that stress will cause the symptoms to re-surface as he heals. Hopefully that is all it is. Please keep us posted.

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We had the pale skin and dark circles also...but both strep infections came in conjuction with a seasonal allergy attack...the dark circles are normal for him when the allergies are present...and that was his tell when he ate something he was allergic to that was going to cause him to throw up...all of a sudden he would get very pale and his under his eyes would get dark...and I would go running for a bowl...

 

Anyway...if you are concerned about a sinus infection...nasal washes would be a good thing...they will get in there and clean out those sinuses...

 

Keeping you and your family in our thoughts..

--Lisa

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Hey Alex,

 

Morgan has also fit that picture. Pale with dark circles worse with Pandas worse, but also with allergies. Much improvement this month with improving symptoms. She no longer has to wear foundation to cover the dark circles before going out the door to school. The more fatigued she was with Pandas, the worse her OCD, the more distant she looked, poor eye contact, distracted, unable to concentrate and use her brain effectively, fatigued, dark circles and pale. I am so sorry you guys are still struggling. Maybe time for full strength antibiotics daily, long term, not profylactic doses.

Ellie

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Same here... pale skin and dark circles under his eyes. It was so bad his preschool teacher and an immunologists mentioned it to me. Two other weird symptoms were cradle cap 'dry scalp' at 5 1/2 and chapped lips all the time. ALL symptoms are gone 4 weeks post IVIG. He is on 250 m.g. Azithromycin daily and 45 pounds.

 

I would say try upping his prophylactic dose of azithromycin. Our son complained of a sore throat about 10 days ago and both rapid/cultured strep test were negative. We saw a flair in symptoms and his younger twin brother and sister were sick. We upped his dose and all symptoms disappeared in 48 hours.

 

-Wendy

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Hi Wendy,

when you say you upped the dose -- do you do this on your own, or you ask the doctor first? just curious. I am trying out abx right now (augmentin) and he's had about 4 doses so far (each is 500 mgs. I think), so just wondering if I don't see any great imrovement after a week, should I up the dose on my own being that I have the stuff in the fridge, :ph34r: . We will have our appt. with Dr. Latimer in November, so I guess I want to be able to have someting to report so I'm not starting at square one.

 

thanks so much for your help. I am on this road now and at least have something to actively find out about, so thanks so much for having pointed me in this direction a few weeks ago.

 

Faith

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Yes.. I did this independently of any Dr's advice and more from OTHER parents recommendation. I'm only doing it for a short period of time - 14 days in total. When decreasing the antibiotic again and if there is another flair or increase in symptoms I will consult with Dr. K to see if a longer term increase should be considered. I'd say based on your son age and size increasing dose might be a consideration down the road. Give the current Augmentin dose a chance to work 'one month' and if you are seeing improvement I'd think you'd be fine until you see Dr. Latimer to help you make the decision.

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Dear Alex,

 

Yes, Yes, my son has very dark circles under his eyes and is very pale. I was just going to post and ask if others have seen this too. We are hoping to do IVIG soon.

 

If the Omnicef is working to lessen the symptoms, can you stay on that prophylacticaly? (sp)

 

 

My son had Plasma Exchange 8 weeks ago and was doing great until he had a tooth infection go undiagnosed for at least a week. Before the tooth was discoverd infected and pulled his PANDAS symptoms were flaring back up. After the tooth was pulled he remained on an antibioitc for several days and had a fantastic day the last day of the antibiotic but started to have PANDAS symptoms flare back up as time went on. In conjunction he started to look worse and worse. He had dark circles under his eyes and a pallor to his skin.

 

We brought him to the Pediatrician on a Friday because I was convinced he had a sinus infection. The ped didn't think so but thought allergies instead. The next day my son had no energy, looked terrible and had a headache and his PANDAS symtoms were awful. We called the Ped's office which was closed but convinced the on call to give us an antibiotic. He has been on Omnicef for 10 days and his PANDAS symptoms have gone way down but my son is still not back to where he was at his best after the PEX. He looks a lot better too, but still with a little bit of dark circles

 

Now I am wondering if the dark circles and pallor were really just a result of the antibody attack on his system from the PANDAS coming back and that the ped was correct that there was no sinus infection. We are worried about what is going to happen after the full stregth omnicef ends and he goes back to prophylactic dose of azith.

 

Anybody else see this type of appearance just from PANDAS?

 

Alex

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