ASO Falling but Anti-DNase B Rising Significantly

[Christianmom]

My son's ASO and anti-DNase B have been tested 3 times (10/2010, 12/2010, 1/2011) and he has been agressively treated with antibiotics since October. Here are the results:

ASO: 240, 171, 146

anti-DNase B: 316, 340, 680

 

Has anyone else had this happened? And what does it mean?

[sf_mom]

Yes, my husband... current anti-DNase is 980 (treated 10 months as a strep carrier and titers went up not down). When we investigated further we discovered PANDAS was not the core issue for our older son but chronic infection is/was. Our entire family has Lyme Disease with co-infections. All three children have congenital Lyme.

[Christianmom]

SF Mom -- So why are you husband's titers rising? If the strep A is gone (as indicated by ASO lowering) shouldn't his anti-DNase B go down as well?

[sf_mom]

We are not sure. Iowa Dawn had a similar problem of titers going up for their family when treated and they too discovered Lyme for many family members. You'll find all the posts in both our history.

 

Anyway, current theory is something... potentially 'chronic infection of Lyme' is preventing them from fully resolving. My husband also has elevated ASO and they too are not resolving at last check he was 244.

 

-Wendy

[matis_mom]

We are not sure. Iowa Dawn had a similar problem of titers going up for their family when treated and they too discovered Lyme for many family members. You'll find all the posts in both our history.

 

Anyway, current theory is something... potentially 'chronic infection of Lyme' is preventing them from fully resolving. My husband also has elevated ASO and they too are not resolving at last check he was 244.

 

-Wendy

Well, that supports my own theory! Both my dh and I are kind of stuck around 250 no matter what. He had confirmed Lyme 2 1/2 years ago, for which they only gave him 3 weeks of abxs. I had all the symptoms shortly after, but did not connect the dots (nor did my doc connect the dots), so I went untreated. Never got a positive, but have been dealing with one thing after the other after that.

[eljomom]

I am just taking a stab here based on what I have "heard"---the DNase may continue to rise for a while---they do so weeks after ASO rises. Honestly, again from what I have "read and heard"---and I shudder to think I am going to say something I've been told by a few "pandas-exists-but-titers-are-it" docs, that people will have all sorts of different "baselines"---some school age children will have your level titers with NO strep (negative cultures, negative symptoms, no pandas) and that just means they have been exposed. Just a thought...

[JAG10]

Christianmom,

 

Those testing intervals are fairly close together, so Eljomom's comments could be in play. There is so much uncertainty, even with measurements that are objective. The BIG question with many of these blood tests is...are they measuring anything else besides what they are reporting to be a measurement of? For my dd who has never once swabbed positive, anti-DNAse B measurements have closely correlated to her degree of PANDAS symptoms in that when DNAse B was over the tilt measure, so were her symptoms. The lower they became, the closer my dd was to "typical." This is not true for all PANDAS children, of course-not much is. But some of us have noted this correlation; Mom MD comes to mind at the moment. No Lyme involvement here, not with Mom MD's either, I believe.

 

IVIG (5/2010) significantly lowered my dd's anti-DNAse B titer, I can't tell you exactly how much because I don't know how high her titer reached, just that it was over 1360, but IVIG decreased it by at least 1000 and her symptoms improved significantly. When we were all exposed to strep in the fall, ASO and DNAse B all rose, but then fell again. Her anti-DNAse B titers haven't come close to rising that high again post-IVIG. Interestingly, my dh and I had elevated ASO but not anti-DNAse B...

 

This may not be relevant to your child whatsoever, IDK. Just thought a different perspective may be of some value.

 

Best wishes for good health!

Jill

[Christianmom]

I forgot to mention that the Januray test was actually 1/31. So the first DNase titer (316) and last (680) were 3 1/2 months apart. So I would think the titer was not still rising because of the original infection. The doctor seems to think the DNase is showing an infection from another type of strep (not strep A) and that it has become resistant to the antibiotics. So we are trying clindamycin 300 mg. (given every 6 hours) with Rifampin for the last 4 days. He said this is considered to be the "strongest availabe strep treatment protocol." I had thought DNase was only an indicator of strep A, but he said it could be an indicator of other types of strep as well. ASO, however, is only an indicator of strep A. We have my son's CamK score (168) and are awaiting the rest of the Cunningham test results. When the doctor sees these results, he will decide what to do next. I would assume it would be best to clear all infection before going to IVIG, but I'm not sure we will be able to get this DNase number to go down. Thank you all for your posts.