PANDAS LABSFERGUSON

NORMVAL<200 <20

STREP <170 <70

<10O

CDC LYME

GENUS SPECIFICS

1a,23,3o,31,34,37,39, 83,93

IMMUNOGLOBULINS

IgG subclasses

Other tests

VITAMINS

CBC

A

-<17o

<O.91

QA “oo‘ _ . 1

Titers

WesternBlot, IgG

WesternBlot, IgM

IgG 483IgA 51IgM 42IgE 4.52

G4_E PROD |gG4*|gE 45.2G4_E R /mo |gG4/|gE 2212389381A_|v|RAT|o |gA/:gm 1214285714

2901452419

>32<4>28

_|961 333IgG2 135|gG3 27|gG4 10

TSHTT3TT4CERULOPLASMINFERRITIN 77ANA

VITA25-OH-VIT D 66.725-OH-VIT D225-OH-VIT D3VIT E

WBCHGBHCTMCVMCHCPLATSMPV

ABSOLUTE NEUTLYMPHSMONOEOS

BASOS

ANTIBODIESye||ow=PREVNARbIue= not |n vaccm

PNEUMOCOCCAL 1 1 o253

, _ _

6

POOR<0 35

0 0 / z a / 2 0 1 1 10:16 FAA 630 656 4046 ADVENTIST LAB PARTNERS [£1001

ADVENTISTHINSDALEHOSPITAL120NOak Street

Hinsdale, IL 60521-3390MedicalDirector: DinoU.Vallera,MD

CL1N1CAL LABORATORY

Hematology ICollectedDateCollected Time

ProcedureWBCRBCHghI-IctPlateletMCVMCHMCI-ICRDWNeuuophils%Lymphocytes %Monocytes %Eosinophils%Basophils %NeutrophilsAbsLymphocytesAbsMonocytes AbsEosinophils AbsBasophils Abs

f

O9/20/20] 1l6:21:0O

l0.464.2912.737.817988 , ]29.633.6l3.6474562O4.874.750.590.210.04

Unitsxl0'3/microLxlO'6/microL

g/dl,%

xI0'3/microLfl.P3g/dL%%

$ 5 9 5 9

%xl0'3/microLx10'3/rnicroLxlO'3/microLx l0'3/microLx1O'3/microL

RefRange[5.00-14.50][$.90-5.30][11.5-13.5][34.0-40.0][150-400][78.0-90.0][24.0~30.0][31.O-37.0][11.5-14.5]

[1.so.s.oo_1ll .50-7,00I[o.1s-0.60][604-0.60][ooo-0.111

éheinistry _I II Chemistry

A ICollected Date 09/20/2011CollectedTime 16:21:00

Procedure UnitsCeruloplasmin 40 H* mg,/dLFerritin 77,0 ng/mL2501-I Vit DLevel 66.7 nyml;

<20ASOTiter

RefRange[18-37]

[130-150.0]1300100.01[<=150]

ILaboratoryResultLegend: '@=Ab|;ormal L=Low H=High C=Cril:ical *=Comn_Lent inc=C0rrected I

Admit? 9/20/201l Pl.Type: OutpalicnlDisch: 9/20/2011DOB: 6/2/2006 Age: 5 years Sex: FemaleRoom/Bed: /PrintDT/TM: 9/29/2011 lU:08:28AMChart Request ID: 14791876

Patient Name: FERGUSON, CAROLINEGRACEMR#: 2236143 ACCT#: 8048964Outreach Client: Adventist HinsdaleHospitalOutreachClient #: I-IINCopy for: ROSARIO TRIFILETTI

Page l of 6

09/29/2011 10:16 FAX 630 856 4046 ADVENTIST LAB PARTNERS

lg

IgGIgGSubclass 1

CollectedDateCollectedTime

Pr ed_l oc ureIgG Subclass 2lggSubclass 3IgGSubclass 4IgMMycoplasma IgGMycoplasma IgMPneumococ IgGType 1PneumococIgG Type l2FPneumococ IgG Type 14Pneumococ IgG Type 18CPneumococ1gGType 191*Pneumococ IgGType. 23FPncumococ IgGType 3PneumococIgG Type 4Pneumococ IgG Type 5Pneumococ IgG Type 6BPncumoeot. IgG Type 7FPneumococ l gb lype 8Pneumococ IgGType 9NPneumococ IgG Type 9V

9/20/20114 2100PM25OHVitDLevel:<10 ng/ITIL Deflciency10 30 ng/mL Insufficicncy30 -100ng/ml. Sufflciency

11.. T' `

<70 *514.52483 L333

09/20/20| I16:21:00

1352710 *42

0.01 *0.01 *0.250.842.471.460.781.940.1]0.261.161.316.500.340.544.78

>1OOng/n oxxclty

11421OOPMI *Leve1:9/20/20 gf.

TOTAI IgEREFERENCERANGES:< 25 l<UA/L Normal25 -100 Borderline>lO0 Elevated

09/20/2011 1621 OOCeruloplasrninzPerformed byARUPLaboratories

ADVENTIST I-IINSDALEHOSPITAL120NOak Street

Hinsdale, IL 60521-3890Medical Director: DinoU.Vallera, MD

CLINICAL LABORATORY

Units/ml. [0-70]mg/dl,kUa/Lmg/dl..mg/dL

Unitsmg/d.Lmg/dl.mg/dLmg/dLUnits/LUnits/Lmcg/mLmcg/mLmcg/mLmcg/ml.mcg/mLmcg/mLmcg/mLmcg/mLmcg/ml.mcg/mLmt‘:gJmLmcg/ml..mcg/mLmcg/mL

500ChlpetaWay SLC,UT84103'300~522-2787

Admit: 9/20/2011 Pt.Type: OutpatientDisch: 9/20/2011

Dnase BAbA

1g,ELevel

www_arup1ab.oon1, Sherrie L.Perkins.MD -Lab.DirectorlLnb0l‘at0l'VResultLegend: @=Abnorma1 L_-1_.ow

[27-l95]

1504-1.464][330-1065]

RefRange[S7-345][8-126][2-116][24-210]

[<=0.76]

H-:I-lnlgh C=-EriticalI

*=C§or'nmentI

c='Corrected IDOB: 6/2/2006 Age: 5 years Sex: FemaleRoom/Bed: /PrintDT/TM: 9/29/2011 10208128AMChartRcqut:$t1D: 14791876

PatientName: FERGUSON.CAROLINE GRACEMR#: 2236143 ACCT# $048964Outreach Cllent: Adventist Hinsdale HospitalOutreach Client#: I-TINCopy for: ROSARIOTRIFILETTI

@0112

Page 2 of 6

|

i

1i1

1i

09/29/2011 10:10 FAX 630 S56 4046 ADVENTIST LAB PARTNERS 003

ADVENTISTHINSDALEHOSPITAL120N OakStreet

Hinsdale, IL 60521-3890MedicalDirector: DinoU.Vallera,MD

CLINICALLABORATORY

__..

i

1 _i . , . -

< - \ . i _ _ \ 4

su ssesgG,g,g g .` ,confumatory and more precise total IgG isavailable by thenephelometric method of total IgG (Test# 00-50350).Performed byARUP Laboratories,500ChipetaWay, SLC.UT 84108 800-522-2787www.arupIab.com, SherrieL.Perkins,MD-Lab.Director09/20/2011 16:21:00 Mycoplasma IgG:REFERENCEINTERVAL: Mycoplasma pneumoniaeAb, IgG0.09 U/Lor less ............Negative0.10 -0.32 U/L .............Equivocal0.33 U/Lor greater ........, PositiveINTERPRETTVEDATA' Over50% ofhealthy adults have arelativelyhigh background of specific.M pneumoniae IgGantibodies in their sera, probably because of past Mpneumoniae infections Therefore, paired sera obtained withii lime interval ot 1 to 3 weeks are highly recommended inadults to confirin reinfection byM pneumoniae, which isdemonstrated byu signilleanichange in lgGantibodies Asignil'i<..int ehange is indicated il one sample is above 0 32U/L and the other is below 0 20U/L

| __ ciiemisiry" " _

09/20/201l.16:21:00 Dnai-ieBAb!Performed by ARUPLaboratories500CliipetaWay, SLCUT84108 800-522-2787www aruplab com SherrieL Perkins,MD-Lab Director09/20/2011 1621 OOIgGSubclass 4INTERPREIATION For ImmunoglobulinGSubclasses 1 4

1"hc. total lgG (mg/dl.)can be derived by the sum ofthebcla I 1 I G2 I G3and I G4 values However a

ILaboratoiResultend: @=Abnormal L=Low H=HiEh C=Critical ':iC0i-nmen; ¢=iC01-“cmd

Admit: 9/20/2011 Pt. Type: Outpatient PatientName: FERGUSON. CAROLINEGRACEDisch: 9/20/2011 MR#t 2236143 ACCT#1 8048964DOB: 6/2/2006 Age: 5 years Sex ; Female Outs-eachClient: Adventlst HinsdaleHospitalRoom/Bed: / OutreachClient #: I-HN1-"rii1iD'l /TM: 9/29/201 l 10:08:28AM Copy for: ROSARIO TRlLF1LET1'IChart Request TD: 14791876 Page 3 of 6

09/29/2011 10:16 FAX 630 856 4046 ADVENTIST LAB PARTNERS li-|004

ADVENTISTHINSDALEHOSPITAL120NOakStreet1

Hinsdale, IL 60521-3890MedicalDirector: DinoU.Vallera,MDCLINICALLABORATORY

1

O9/20/201 l 16:21:00 Mycoplasma IgM:REFERENCEINTERVAL: Mycoplasma pneumoniae Ab, IgM0.76 U/L or less ..........Negative:No clinically

significant amountofM. pneumoniae IgM antibodydetected.

0.77 -0.95U/L .........._ LowPositive:M. pneumoniae-specific IgM presumptivelydetected. Collection of afollow-up sample in I-2weeks is recommended toassure reactivity.

0.96 U/L orgreater .......Positive:Highly significantamount ofM.pneumoniae-specific IgM antibodydetected. However, low levelsof IgMantibodiesmayoccasionally persist for morethan I2 months post-infection.

Performed by ARUPLaboratories,500ChipetaWay, SLC.UT84108 800-522-2787www.aruplab.com, SherrieL.Perkins,MD -Lab.Director

I Mlsealaneous LabTests-I I

CollectedDate 09/20/201lsCollected Time 16:21:00

Procedure Units RefRangeInlcrp SecNote *Arup Result 1 SEENOTE *

|Laborato§ResultLegend: @=Abnot-mal L-'=T'ow__H=High C=Critica| -'*=Eomment _§=|-'Jen-e¢¢¢d_ IAdmit: 9/20/2011 Pt.'l ypC: Outpatient Patie|1lNamC: FERGUSON.CAROLINE GRACEDisch: 9/20/2011 MR#: 2236143 ACC1 #: $048964DOB: 6/2/2006 Age: 5 years Sex: Female Outreach Client: AdventistHinsdale HospitalRoom/Bed: / OutreachClient #: I-IINPrin1;D'l`/TMI 9/29/2011 10:08:28AM Copy for: ROSARIOTR.lFll.E'I"l IChanRequest ID: 14791876 Page 4 of 51

09/29/2011 10317 FAX 630 856 4046 ADVENTIST LAB PARTNERS

ADVENTISTHINSDALEHOSPITAL120NOak Street

Hihsdiilii, IL 60521-3890MedicalDirector: DinoU.Valleni,MD

CLINICALLABORATORY

s .1 v i 1 \ i ,

1 1 s

i- ~. .s s,

' ' ‘ ,

' ‘ " __ il ii iv _

Long-term protectionis generally thought to be associatedwith a onemonthpost-vaccine response of at least 1ug/mLinchildren and adults. Responder status isdeterrnined,once reaching the minimum level of 1ug/mL,according tothe ratioofposivaccination topri-:vaccinationconcentration of pneumococcal IgG antibody as follows:

A ratio ol less than twofold is considered sinon responderA isitio of two to fourfold is 4 wesk responderA tin of fourfold or eater is agood responderr 0 gi'

A response togreater than 50%of the antigens contained inthe vaccination is rriost likely indicative of anormalresponsePeriormcd by ARUPLaboratories,500ChipetaWay, SLC.UT 84108 800-522-2787www aruplab com Sherrie L Perkins,MD Lab Director

|€-.IUU5

1 Miscellaneous LabTests i09/20/201 I 16:21:00 Iriteip: '

INTERPRETATION: PneumococcalAntibodies, IgG

Includes serotypes l 3, 4* 5, 6B* 7F 8, 9N 9V* 12_1=I4* 18C* 19F* 23F*

All serotypes tested are present in the 23-valent purcpolysaccharide pneumococcal vaceinc The serotypesmarkedwith an asterisk . i re contained in theConjugatedpneumococciii vaccine

This assay is designed to useboth pre" and post samplestoassess i m m u n e responsiveness to vaccination This testis not designed to deten-nine protection toStreptococcuspneumoniae based on.i single sample

Laboratory ResultLe end @=Abnot'mai L=L0w H=Hi§h C=Cl1tlcal *= ( omment c=C0|-rcgtedE H U ' is

Admit: 9/20/2011 Pt. Type: Outpatient PatientName: FERGUSON.CAROLINE GRACEDisch: 9/20/2011DOB: 6/2/2006Room/Bed: /PrintDTfI`M: 9/29/2011 10:08:28AMChartRequest TD: 14791876 Page 5 of 6

MR#: 2236143 ACCT#: 8043964Age: 5 years Sex: Female Outreach Client: Adventist HinsdaleHospital

Outi-each Client#: 1-HNCopy for: ROSARIO TRIFILETTI

09/29/2011 10:17 FAX 630 856 4046 ADVENTIST LAB PARTNERS @1003

ADVENTISTHINSDALEHOSPITAL120NOak Street

Hinsdale, IL 60521-3890MedicalDirector: DinoU.Vallera,MD

CLINICAL LABORATORY

| ' _ '-Twisee||ane'8ueLabT'~==-$13

___ ' _ ' " |09/20/2011 16:21:00 Arup Result 1:Test name Result Units Retlntvl

Srreptozyme Screen NoneDetetztcd NoneDetectedStreptozyme Titer NotDone units < 100

BBCHUSC the Streptozymc screenwas negative; theStreptozyme titerwas not perfomed.PerformedbyARUP Laboratories,500ChipelaWay, SLC.UT 84108 800-522-2787www.arup1ab.com, SherrieL. Perkins, MT)-Lab.Director

|I_.aboratorvResultLegend: @=Abnormal, L=Low H=Hiah C=Critica1 *=(fo_Lr1ment c=C0n-cctezl IAdmit: 9/20/2011 Pt. Type: Outpatient PatienlNameI FERGUSON.CAROLl'NE GRACEDisch: 9/20/2011 MR#: 2236143 ACC’I #: 8048964DOB: 6/2/2006 Age: 5 years Sex: Female OutreachClient: Adventist HinsdaleHospitalRoom/Bed: / OutreachC1ienL#: HINPrint DTfT'M: 9/29/2011 l0:OS:28AM Copy for: ROSAR1() 'l`R_lFlLE'ITIChart Request ID: 14791876 Page 6 of 6