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So I'm unclear based on the article and some other reading around, can a strep test detect PANDAS, at least in some cases?

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PANDAS is better described as a syndrome of symptoms all occurring at once. It's caused by strep (and in our case at least) can also be triggered by covid vaccines or other things as well) so a strep text only tells you if the child has strep. In our case, the treatment was the test, in that if it didn't work, it would (arguably) help rule it out. But it did work, for which we're grateful.

According to the conventional PANDAS theory, due to biological mimickry antibodies against Step A bind to neurons and attack them, so there are antibody tests that focus on Strep A that are used as diagnostic tools in PANDAS, such as antistreptolysin O (ASO), anti-DNAse B (ADB), and streptococcal carbohydrate (anti-CHO).

However, there a lots of kids diagnosed with PANDAS who have high levels of those antibodies at some times but not at others, and there are kids with the exact same history and presentation who never show high levels of those antibodies at all. So it could be that there are actually a wide variety of situations in which antibodies that the body creates end up attacking neurons (see anti-NMDA encephalitis), and only some of them are even known about yet.

Wow, thanks for such a well-researched reply.

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