Home » Tests for PANDAS

Tests for PANDAS

I thought it may be helpful to review some possible tests that are being used to determine whether or not a child has PANDAS. Though there are many tests for PANDAS to assist in diagnosis, nothing replaces a good history both medically and behaviorally.

Rapid strep: A rapid strep is the test used in most pediatricians offices when a child has a sore throat. The back of the throat is swabbed and then tested for the strep bacteria. Roughly half of children with PANDAS will test positive, often with no signs or symptoms of strep.

ASO titer: This is a test which requires a blood draw. It measures the level of strep antibodies in the blood to determine if there has been a past infection. ASO levels peak 4-6 weeks after an infection and then begin to fall. One test will give you a number which a lab then has variables for what is normal. It is most helpful to retest in about two weeks to see if the number is rising or falling. Some labs have different variables…one might see anything above 150 as high and one might see anything above 400 as high.

Anti-DNase B: often used with the ASO titer to confirm previous strep infection.

CaM Kinase tests: This is a test for PANDAS to determine if a specific antibody can cross the blood brain barrier from what I understand. It is not diagnostic, but research in this area is promising and Dr. Cunningham down in Oklahoma is tirelessly working to further develop and complete more testing.

Steroid burst: Some drs use a 5 day steroid prescription to determine if the body is having an autoimmune response. If the child has true Tourettes or OCD, the behaviors become worse. If the child is having an autoimmune response to strep, they will usually improve by day 3 on steroids. This is used as a diagnostic procedure by some physicians.

Though there are no absolute, conclusive tests for PANDAS, the research is coming quickly.

In our case, we tested positive on a rapid strep with no signs or symptoms of strep. Since we had a previous history of Scarlet Fever…that gave us our 2 tests necessary for a diagnosis. We ran no bloodwork prior to our first IVIG. In hindsight, it would have been nice to know what the numbers were. 3 months after the first IVIG, when Joshua started slipping after a few illnesses, we ran tests for immune function as well as for mycoplasm (this is a bacteria that causes pneumonia…it is correlated with the more violent PANDAS children) for which we tested negative.

Leave a Reply

Your email address will not be published. Required fields are marked *