Questions and Answers
What are the diagnostic criteria for PANDAS?
• Presence of obsessive-compulsive disorder (OCD) or a tic disorder
• Prepubertal symptom onset
• Acute symptom onset and episodic (relapsing-remitting) course
• Temporal association between Group A streptococcal infection and symptom onset/ exacerbations
• Associated with neurological abnormalities, (particularly motoric hyperactivity and choreiform movements)
Are there any other symptoms associated with PANDAS episodes?
Yes. Children with PANDAS often experience one or more of the following symptoms in conjunction with their OCD and/or tics:
1. ADHD symptoms (hyperactivity, inattention, fidgety)
2. Separation anxiety (child is "clingy" and has difficulty separating from his/her caregivers; for example, the child may not want to be in a different room in the house from his/her parents)
3. Mood changes (irritability, sadness, emotional lability)
4. Sleep disturbance
5. Night- time bed wetting and/or day- time urinary frequency
6. Fine/gross motor changes (e.g. changes in handwriting)
7. Joint pains.
Could an adult have PANDAS?
No. By definition, PANDAS is a paediatric disorder. It is possible that adolescents and adults may have immune mediated OCD, but this is not known. The normal range of test panels is established from paediatric serum samples.
Will “The Cunningham Panel™” of tests be for just PANDAS or will it also test for PANS?
PANDAS and PANS are clinical diagnoses rather than laboratory diagnoses at this time. “The Cunningham Panel™” will test for autoantibodies against four neurologic receptors or antigens and test if antibodies in the patient serum can induce activity in neural cells. These autoantibodies have been associated with both PANS and PANDAS. The term “PANDAS” indicates that the infectious agent is related to a streptococcal infection. We do not test for streptococcal infection or anti-streptococcal antibody titers. The term “PANS” indicates that the origin of the neurologic condition is undefined. The current testing will be focused on the anti-neuronal antibodies and their associated neuronal cell stimulation found in both PANDAS and PANS.
Will treatments such as antibiotics, steroids, IVIG and Plasma Exchange interfere with the results of “The Cunningham Panel™” tests?
Certain immune modulatory therapies can alter testing results since one of the reasons to administer these treatments are to decrease antibody titres. The therapies include steroids, IVIG and Plasma Exchange. For this reason we recommend that a time lapse of at least 6 weeks occur between the last treatment and drawing blood. We are currently unaware of any antibiotics that interfere with the results of the tests.
How long will it take to get the results from “The Cunningham Panel™”?
There are 5 sets of tests in the Cunningham Panel™, and each test is performed in duplicate and triplicate. One assay requires a lengthy cell culture process. Initially, we estimate that turnaround time for testing (from receiving a specimen to having results available for the physician) will be approximately 8 weeks.
What does it mean if all results from “The Cunningham Panel™” come back with negative results or in the normal range?
If all results come back with negative results or in the normal range, it does not necessarily mean that the child does not have PANDAS/PANS. Test results can be affected by the condition of the patient at the time the patient’s blood was drawn, and whether the patient has been on immunomodulatory treatments. In addition, the current “Cunningham Panel™” is comprised of 5 tests, and there is a possibility that additional neurologic antigens/receptors that are not yet identified may be involved in this condition. There is ongoing research for other potential autoimmune neurologic targets. Because PANDAS/PANS are clinical diagnoses and not laboratory diagnoses, it is important that the physician weigh the clinical symptoms with the laboratory results in making a diagnosis.
How do I order the “The Cunningham Panel™”?
If you would like to order the “The Cunningham Panel™” as a parent please contact a physician that can order the test directly from Wieslab. A physician must order the “The Cunningham Panel™” of tests before we can process the specimen and the physician will receive the test report.
- Please print and fill out one of the request forms that you can find on this page. Remember to fill out the request form completely with patient data and contact details. Tick test panel 564 to order "The Cunningham Panel™" if you are using the request form for neurology testing.
- We will send the test report to the physician / hospital / clinic specified on the request form under contact person. If the contact person is different from where the invoice should be sent please specify this clearly on the request form.
- Take a venous or capillary blood sample in a polypropylene tube without additive, let the sample clot and centrifuge it. Send the sample (1-3 mL serum) by courier to: Wieslab AB, Lundavägen 151, 21224, Malmö, Sweden. Send the sample in a small box with the test tube inside wrapped in bubble wrap.
- The test panel is complicated and takes several weeks to perform. Consequently a test report takes up to 8 weeks to be delivered to the requesting physician.
What is the cost of ordering “The Cunningham Panel™” through Wieslab?
Please write an email to firstname.lastname@example.org for information about the price
How do I pay for “The Cunningham Panel™”?
Wieslab will send an invoice when the sample report is ready. The invoice is to be paid via bank transfer. Once the invoice is paid the test report will be submitted.