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PANS/PANDAS: Lab Testing

PANS/PANDAS is a clinical diagnosis. Laboratory testing may determine an infectious trigger, rule out other diagnoses, and aid in the development of a treatment plan. Refer to the diagnostic flowchart for additional guidance in evaluating patients and lab test considerations for PANS and PANDAS.

Initial testing

  1. Strep A rapid test and throat culture
    1. If negative, check ASO and AntiD-Nase-B
  2. CBC with differential to check for other infections
  3. Perianal strep swab, if indicated
  4. Anti-nuclear antibodies
  5. Quantitative immunoglobins (IgG, IgA, IgM, IgE) with IgG subclasses
  6. Urinalysis to assess hydration and rule out UTI when urinary complaints are present

Additional considerations depending on presentation and symptom severity:

  1. ENT referral for tonsil and adenoid evaluation
  2. Cunningham Panel™
  3. MRI and EEG study
  4. Sleep study to evaluate sleep disturbances
  5. Swallowing study to evaluate possible cause for restrictive eating
  6. Lumbar puncture