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Help with Strep Titer LABS please


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I have the printout of my DD11's strep titer labs that were taken on 12-22. I am confused about these as they seem to be low and wondering if this means that she does not have strep... or PANDAS? ???

 

Here is what I see on the printout:

 

General Serology:

Antistreptolysi... 52.7*

 

Also, I thought there were 2 strep titer labs: ASO & DNASE ?? I don't see those listed... is the one above one of those? Thanks in advance for any help...

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That looks like its the ASO. Low ASO and low AntiDnase do not mean anything. Elevated titers can confirm recent strep infection, but low titers do not mean there is or was no infection.

 

Here's a thread w/ titer info:

http://www.latitudes.org/forums/index.php?showtopic=3756&st=0#entry29305

You can find this and more info in the Helpful Threads for PANDAS thread pinned at the top of the PANDAS/PITANDS page.

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HI browneyesmom,

I wanted to let you know that the absence of risen titers in one of my PANDAS (infact, the more severe one (simliar in presentaion to yours!)was not an issue for the PANDAS doc we see. The other child had two definite strep events connected with her onset and exacerbation. Our doctor (excellent PANDAS doc) said that strep could have started the auto-immune ball rolling ages ago, and any virus, bacteria would cause the exacerbation we saw- well, exacerbation is not really the word, as it never remitted more than 20% at any time until prednisone!

 

also, i took my 14 yo (who is a strep carrier in his tonsils!) to an ID doctor here. He seemed possibly slightly PANDAS skeptical, but he told me that titer are essentially pointless- as they can stay raised for years (i think he said 3) after a strep infection. he felt like I should just rely on throat cultures in my kids to determine if anyone is a carrier. I know that strep can be lesewhere and that is not my point now- but he just did not worry at all about the titers either way. I have not seen our PANDAS doc to report back after ID visit and I imagine there may be a difference of opinion there.

Edited by rockytop
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Denise, That looks like the ASO and yes, that is low, but it doesn't rule out pandas. Strep titers rise over time, like 4 to 6 weeks at least. Also, some people's titers do not rise even after a proven strep infection. Dr. B has stated this. I am sure the antidnase b was probably ordered if Dr. B is involved in her care now, and that one does take longer to come back.

 

Also, remember that this is all really PITAND, infection triggered neurological disorder. It could be strep, mycoplasma pneumonia, lyme, virus etc. Your pandas doc just has to figure out what works for your child over time. Dr. B will order all the bloodwork you will need if he hasn't already.

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