Help me decipher bloodwork results

amother

Green

Mon, Dec 09 2024, 2:26 pm

amother OP wrote:

Child #1:
DNASE B Antibody: 711
ASO Anti-streptolysin o: 234

Carbon dioxide: 17 (this is the second time her levels are low for this test. What could be the reason?)

Child #2:
DNASE B Antibody: 742
ASO Anti-streptolysin o: 186

Please help me decipher this until I discuss with pediatrician. Does this mean they both have pandas?

The laboratory results and clinical scenario suggest possible immune system activity related to recent or past streptococcal infections, which can raise concerns for **Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)**. However, confirming PANDAS requires clinical assessment beyond lab results. Here's a breakdown of the labs and their potential implications:

---

### **Child #1**
1. **DNase B Antibody: 711 (elevated)**
- Indicates a previous **Group A Streptococcal infection**, as DNase B antibodies rise after strep exposure.

2. **ASO (Anti-streptolysin O): 234 (elevated)**
- Another marker of recent or past strep infection.

3. **Carbon dioxide (CO₂): 17 (low)**
- **Normal CO₂ levels** typically range from 22-28 mmol/L. Low levels may indicate:
- **Acidosis** (metabolic or respiratory), potentially from dehydration, kidney dysfunction, or other metabolic disorders.
- **Compensation for respiratory alkalosis**, often seen with hyperventilation.
- Consider repeating the test and evaluating kidney function, bicarbonate levels, or acid-base status with the pediatrician.

---

### **Child #2**
1. **DNase B Antibody: 742 (elevated)**
- Suggests prior strep infection, similar to Child #1.

2. **ASO: 186 (elevated)**
- Indicates prior immune response to streptococcal infection.

---

### **Does This Suggest PANDAS?**
PANDAS is a clinical diagnosis, not solely based on lab markers. It is characterized by sudden-onset **Obsessive-Compulsive Disorder (OCD)** or **tics** following a strep infection, alongside other neuropsychiatric symptoms like anxiety, urinary issues, or behavioral changes.

- **Lab results like elevated ASO and DNase B antibodies** are supportive but not diagnostic of PANDAS.
- Many children with strep infections show elevated ASO or DNase B titers without developing PANDAS.

---

### **Next Steps**
1. **Monitor Symptoms**:
- Look for neuropsychiatric changes (OCD, tics, anxiety) or regression in developmental milestones.
- Note any physical signs, like sore throat, fever, or behavioral issues, which could signal active or unresolved infection.

2. **Discuss CO₂ with Pediatrician**:
- The low CO₂ in Child #1 warrants further investigation to rule out any underlying metabolic or respiratory concerns.

3. **Collaborate with the Pediatrician**:
- Share both lab results and detailed observations about the children’s behavior and physical health.
- The pediatrician might recommend throat cultures, further strep testing, or refer to a specialist for neuropsychiatric evaluation if PANDAS is suspected.

In conclusion, elevated strep antibodies suggest prior infections but do not confirm PANDAS without matching symptoms. Low CO₂ in

amother

Dimgray

Mon, Dec 09 2024, 2:42 pm

amother Green wrote:

Hi AI !

OP there's no blood test for pandas. Elevated strep titers in conjunction with behavioral changes can indicate pandas.

What's been going on with your kids?