American Asperger's Association Support Group

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Lab tests for people on the spectrum

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1 Lab tests for people on the spectrum on Sat Jan 24, 2009 7:02 am

csweepigirl

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Testing for autoimmune disorders generally begins with the blood. There are a number of individual tests and panels of tests that are used by immunologists, rheumatologists, and other doctors. Because every person with ASD's are unique, you'll need to discuss test options with your physician. Here are some of the tests that physicians might use:

Blood count. Depleted white blood cells indicate that there is a virus or other infection active somewhere in the body.

Sedimentation rate. This test measures how quickly the red cells separate from the serum in a test tube. With normal inflammatory or auto-immune diseases, they separate quickly. Some clinicians have reported a very low "sed rate" in 35 to 40 percent of children with PDDs, indicating that a contradictory type of auto-immune reaction could be taking place.

General chemistry panel. Generally abbreviated as "Chem," and followed by a number that indicates how many tests were performed (Chem-16, Chem-25, etc.) The basic Chem panel checks levels of glucose (blood sugar), Blood Urea Nitrogen (BUN), Creatinine, and electrolytes (including sodium and potassium).

Immune panel test. This general screen may include a search for antibodies, mitogen, antigen, and lymphocyte surface markers; and blood tests for various specific immune-dysfunction markers.

Anti-Neuronal Antibody (ANA) screen. The ANA looks for antibodies to brain tissue in the bloodstream. Their presence is a general indicator for a variety of auto-immune disorders, such as Lupus. Note that the Anti-Nuclear Antibody test, also abbreviated as ANA, may also be ordered. This test is part of the screening procedure for several auto-immune inflammatory diseases.

Tests that look for unusual levels of specific viral antibodies, perhaps including those associated with the Epstein-Barr virus, other human herpes viruses (HHV6, HHV7, HHV8, HSV-1, HSV-2), chronic mononucleosis syndrome (CMS), cytomegalovirus (CMV), rubella (German measles), and, if PANDAS is suspected, titers for group A beta-hemolytic streptococcus (ASO or ASLO). Some may order the antiDNAase B titer as well, although the current view is that this test won't tell you much.

Tests to check for immunoglobulin G (IgG) subclass abnormalities (IgG1, IgG2, IgG3, IgG4), which are found in patients with increased susceptibility to viral or bacterial infections due to a compromised immune system, autoimmune diseases, and immune-mediated neurological disorders. It's possible to plot the distributions of IgG sub-types against patterns associated with specific viruses or conditions.
Amino acid profile. Markers for an impaired immune system include low amounts of the amino acids lysine and arginine.

NeuroSPECT. This brain scan shows the diffusion of blood through the brain, indicating areas of low and high activity. In some people with PDDs, findings include low activity in the temporal lobe and sometimes in other regions of the brain.

Allergy tests. These can include the common skin test (mostly for environmental allergens), the RAST test (generally used for food sensitivities), and more-precise tests of blood, stool, or urine samples.

Tests for celiac disease. These may include blood tests for IgG and IgA Gliadin Antibodies (IgA AGA, which is the most specific of these two tests); IgA Reticulin Antibodies (IgA ARA, R1 type, a highly specific test); and IgA Endomysial Antibodies (EmA).

Tests for Candida albicans. Possibilities include microscopic stool exams, or blood serum or urine D-arabinitol (a Candida metabolite) levels. Although not definitive, elevated immunoglobulin M (IgM) levels suggest active or recent infection. IgG antibodies may be present long after the Candida is cured, so they don't necessarily mean anything. Remember, it is normal to find some Candida in the body. Only severely elevated findings should be a cause for concern.

Coloscopy. For serious GI-tract problems, this invasive test is performed by a gastroenterologist.
A multi-faceted immune panel can turn up many small pieces of evidence that, taken together, indicate a compromised immune system. Findings that may mean trouble for patients with PDDs include elevated CD4 and CD8 counts, or very low CD8 counts; low levels of Natural Killer (NK) cells; and elevated numbers of B cells (the cells that produce antibodies to disease).

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