What will AntiDNAse B actually tell us?

[problemsolver]

And what do we do with the findings?

[laure]

And what do we do with the findings?

 

 

So this number will tell you if your child currently has a high antibody count, meaning that she/he is fighting strep or possibly something else. In our experience the numbers were high enough to indicate treatment with antibiotics without question in everyone's minds, and keep us out of the psych ward! Neuropsych symptoms were my daughter's only symptoms, so the high anti dNase B count was a life saver.

[LNN]

Anti DNase B is a lagging indicator of the body's immune response to a strep infection. It generally rises 4-6 weeks after an immune response is initiated. Elevated titers can linger for some time. So it's a look in the rearview mirror.

 

ASO titers generally rise 1-3 weeks after the immune response is initiated and then will return to baseline fairly quickly. It's an earlier indicator.

 

If you miss the brief window to catch a rising ASO, then elevated Anti DNase B is another opportunity to measure an elevated response. However, one measurement by itself is less meaningful then a series of measurements, due to the slower tapering down of this marker. So you'd be looking for a rise, which would support a suspicion that there was an ongoing infection or a decline, which would indicate that the infection was in the process of or was cleared.

 

Labs have ranges of "normal" but each individual has their own range of normal. Some people have naturally low titers while others have naturally high levels. So what's more telling is the direction of movement, rather than any single measurement.

 

You will hear from a number of parents that their kids don't show elevated titers even with confirmed strep. And even with kids who do respond with elevated titers, there's an optimum window to do these tests (i.e. 1-3 weeks post-infection for ASO, 4-6 weeks for AntiDNase B.) The results have to be put in context of when you suspect the infection, as timing can be a big factor on the results. Thus, the direction of multiple tests is what's really telling.

 

Also, keep in mind that symptoms are more important as a guide. ASO and Anti DNase B are strep titers. Other infections can also trigger a PITANDS response. One other indirect way of looking for ongoing infections is to look at immune complexes. Elevated complexes indicate an active immune response. There are 3 immune complex measurements that are discussed most - C3d, which is a general infection measurement, C3a, which is commonly associated with lyme and C4a, which is sometimes implicated in lyme but more often in chronic mold exposure. Again, not all patients will have elevated complexes. But if you do, it's a good indication of infection (of something).

Edited June 14, 2011 by LLM

[kimballot]

And what do we do with the findings?

 

ASO titers are believed to rise within 3-6 weeks of strep infection, and antiDNAse B rises 6-8 weeks after a strep infection. Also, ASO falls more quickly than DNAseB when the infection clears. So, having elevated levels of either one or both does not guarantee that you have strep at the current moment, as the strep could have cleared in the very recent past and that would not be reflected for a week or two. A lack of elevated titers also does not mean that there is no strep, as the titer could be on the rise OR the child could have an immune deficiency that prevents the child from generating enough antibody to measure as elevation.

 

So - the best way to use these measures is to do repeated measures to see if the numbers are rising or falling, recognizing that there can be a lag of a couple weeks between the changes in the infection and the titer numbers.

 

 

If you are looking for great information on any of the blood tests or research, look for Buster's posts on the forum. He has not been on much lately, but he is the person who has really pulled together the research that is found on PANDAS resource network and on PANDAS network, and he has helped us all to understand things much better.

 

Here is a link to a thread where there was much discussion about ASO, DNASEb and Cam Kinase - it may make your head spin the first time through, but it seems that this might be the kind of information you are looking for. http://www.latitudes.org/forums/index.php?showtopic=5141

 

Also - if you click on Buster's name on the post, it will bring you to his page - then you can click on "find my content" and you can read all of Buster's words of wisdom!

[JJMom39]

Does anyone know what it means when AntiDNAse B falls more quickly than ASO or normalizes before ASO? This is the case for my ds right now. His ASO is still elevated but coming down, but his AntiDNAseB has just come to within the normal range. This is not what I would have expected.