Can a child have strep throat once or twice before developing PANDAS and also, if the child has strep throat, will the ESR and CRP be elevated?  Or is there a circumstance in which they would not be elevated with a strep throat?

Thank you,

Hi, Nancy,

The CRP and the ESR are non-specific markers of inflammation and can be elevated briefly with a lot of illnesses, including routine strep. We generally don't check these tests in routine strep, for they are of little value.   Generally the thought is you have to have strep once and maybe twice to get the antibody response directed at parts of the brain, although this is still somewhat mysterious.

Good luck, Dr. Olson


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David Olson, MD


I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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