sibling's strep and myco P results borderline

[KaraM]

Ok - so we got the results back for my nonPANDAS son whom Dr. B. thinks may be exposing my PANDAS daughter.

All my daughter's results were in the normal range and for the 4th time in a row, have trended downward.

 

My son's results, however, are not so straight forward.

 

ASO (normal reference 0 -640) up and down - always in the high normal range - does this mean possible carriage

June 585

July 607

Oct 539

Dec 555

 

Anti DNAse (ref 0 - 375) - started positive, trended down until this last draw, it started up again (but still in normal range)

June 420 +

July 381 +

Oct 346

Dec 365

 

Myco P -

Ab IgM 1.11 (normal <= .90) so it's elevated - but is this elevated enough to mean an active infection now or is this just indicating infection in the past? He's had pneumonia 3 or 4 times between the ages of 3 and 10.

Ab IgG 0.24 (normal <= .90) so in the normal range

 

I got these results over the phone from the pediatrician's office, based on an order from Dr. B. The nurse at the pediatrician's office doesn't really know what to make of it and I haven't been able to connect with dr. B yet. So I'm just looking for any insight anyone may have...

 

Does exposure to Myco P cause exacerbations the way that exposure to strep can for a PANDAS child?

[Fixit]

 

Does exposure to Myco P cause exacerbations the way that exposure to strep can for a PANDAS child?

 

I'm begining to think so...and see no reason why the panda child would only react to strep ...if they have had prior myco p infections...i would think their body would respond by sending out antibodies and do the same thing in reaction to an attack..JMHO

[Worried_Dad]

ASO (normal reference 0 -640) up and down - always in the high normal range - does this mean possible carriage

June 585

July 607

Oct 539

Dec 555

 

They're telling you the "normal" ASO titer range goes all the way up to 640?!? That seems way off to me. I know there are differences of opinion among labs / docs, but most consider anything above 160 to be positive, or at least above 200. I've seen a few online references that move the upper range to 330 for school-age children... but your son's results in the 500-600's seem unequivocally elevated by almost every published standard.

 

I know the trend is more important than the absolute value, but these sure seem high. And when docs dismiss elevated titers with "oh, your son/daughter just naturally runs high," that's a major cop-out from what we've experienced.

 

I'd double-check with Dr. B about those ASO levels, for sure.

[KaraM]

i would think their body would respond by sending out antibodies and do the same thing in reaction to an attack..JMHO

 

A concept I'm still struggling with - are titers and antibodies the same thing? related? does a titer indicate the presence of a certain antibody?

So, assuming my daughter is a child who does get elevated titers with an infection, would her titers rise if she was fighting exposure to an infection her brother has?

Her titers have been trending down for the four times she's had blood drawn and have been in the normal range the last two times.

 

I'm so confused...

[KaraM]

Or annual physicals with the pediatrician are today at 3:30. I'm hoping to get antibiotics for my nonPANDAS son...Keep your fingers crossed for me!

[smartyjones]

kara -- hope things go well for you at the visit. so -- your daughter has pandas and your son has no symptoms with those titers?

 

sorry, not to make you worry about your son -- i've never gotten a good explanation from anyone i've asked (and my kids do show titer rise) -- it makes sense to me that if you were a carrier - and therefore, benign (although i don't believe there is such a thing), you would not have a rise in titers b/c the strep would be a non-harmful part of your bacterial make-up and your body would not need to fight against it. i am the last one that should be giving scientific opinions. . . but, i would think a rise in titers signifies the body is trying to fight something harmful.

 

 

[KaraM]

Well - the pediatirican does not agree. No abx for my son.

 

Correct - he does not have PANDAS, my daughter does.

 

The myco plasma pneumonia test that we thought was positive, was actually negative after they did a second level of testing.

 

He doesn't see an issue with the titers - says the scale of 0 -640 shows them as in the normal range and that the fluctuation is normal.

 

He did order another round of strep tests, though, and did a throat culture. He also ordered some IgG Ige and some other tests to see if he has deficient iron. So at least he's not just writing us off completely.

 

kara -- hope things go well for you at the visit. so -- your daughter has pandas and your son has no symptoms with those titers?

 

sorry, not to make you worry about your son -- i've never gotten a good explanation from anyone i've asked (and my kids do show titer rise) -- it makes sense to me that if you were a carrier - and therefore, benign (although i don't believe there is such a thing), you would not have a rise in titers b/c the strep would be a non-harmful part of your bacterial make-up and your body would not need to fight against it. i am the last one that should be giving scientific opinions. . . but, i would think a rise in titers signifies the body is trying to fight something harmful.