Anyone have an all-inclusive list of labwork recommended for a child s

[AmySLP]

I have a friend whose child was seen by an ENT who mentioned her son may have PANDAS. Her pediatrican is willing to order whatever necessary, but doesn't know all the components necessary to test. My daughter's file where I have this info is at my office & I am unable to access it b/c I'm sick with pneumonia (& strep test I requested was positive). Anyhow, I'm wondering if any of you have a list of all labs recommended-ie. titers, lyme, Igg, Iga etc. Thanks so much, Amy

[norcalmom]

http://www.latitudes.org/forums/index.php?showtopic=6688

That is a flow chart that can help guide you in diagnosis. It's impossible to give you one list, each child will be different.

Since there isn't a pandas test (although I would recommend the cunninhams tests ) it is a diagnosis reached by ruling out everything else.

In addition, finding any existing infection that is causing the pandas is important too.

A start would be aso, Bnase titers . Strep cultures for the whole family. Immune panel work up- all the basics plus subclasses and pnemoniae titers(but NOT the challenge test if the fail these). CBC, celiacs, allergies.and Lyme.

It's more than one trip to the lab...more like 3..or 4, and o would find immunologist to consult with for sure. Even a non believer will order bloodwork for you.

Some of the tests may lead to other tests or exclude other tests.

So if child has high titers, might not need a Cunningham test. But if you don't find evidence of strep infection, might want to spend the $ on cunninham test, and Lyme.

In our case I did 11 vials of blood first time to lab. Ruled out allergies, lead, mercury, mineral deficiencies. Next stop...gastroenterologist, ruled out celiacs and host of other gut related stuff. Next stop, immunologist (gastroenterologist uncovered igg deficiency..which led me there). He uncovered more immune deficiencies. Then we got cunnningam test.

Mind you- we found a psychiatrist that dx'd pandas before gastroenterologist-so ds was on antibiotics most of this time. Even without strep "proof".

Good luck! I wish I had busters flow chart when I started out...I probably could have avoided some tests. I highly recommend getting pediatrician to prescribe lydocaine before first blood draw. Since kids probably going to be gong back again in near future (our tube has lasted forever). But we didn't have it for the first draw..the 11 tube full allergy panel..and that has caused anxiety over the lab ever since!