Step Titers...

[fightingmom]

Okay, strep titers are not something we normally did until the last few months. I don't really get them. From what I have read is that ASO starts to go up and usually peaks at about 3-4 weeks from start of infection and then drops down quickly. DNase B tends to show elevation if there was a recent infection, but usually not active anymore. Is that right?

 

An increase in either indicates exposure? However, they should be monitored more closely in this case, like a few weeks apart...that's what I'm grasping, please correct me.

 

On December 19th my son's results were as follows:

ASO 69

DNase B 122

 

March 15th

ASO different lab, no number given, just reads "negative" not sure if that means it's completely negative or if within a certain range they don't report the number.

DNase B 273

 

Now, I know the 273 number isn't hugely elevated but it's more than double what it had been 3 months prior and he was sick during this time with sinus infections that we still haven't kicked. We started treatment for those in February - abx 10 days x2 prior to the testing in March. Not sure if it would make any impact.

 

What I'm trying to understand is if there is any signficance in the increase? does it suggest he had strep some point within these 3 months, or no? If so, it's likely that Dr. B's assumption that strep is hiding out in our sinuses may be correct because the sinus infections seem to be the constant issue. thoughts?

 

Oh and anyone have any clue as to why this doctor would check my son's cholesterol but nothing else? No CBC, just lipids panel?

Triglycerides were VERY high. Range 0-149 and my sons were 258!! -- this was never even mentioned to me.

 

----JUST NOTICED MY TITLE HAS A TYPO. OOPS!

Edited May 1, 2012 by fightingmom

[fightingmom]

Shamelessly bumping my own post. Can anyone help me with this?

In summary, I'm just trying to determine if this increase in titers suggests that he did have strep at some point between Dec. and March. It would help me gain a lot of perspective to know this.

[trggirl]

fightingmom, Buster did a great post explaining about the titers. I am running our the door now, but I will try to find it tonight.

[fightingmom]

Thanks! I'm going to search for it now, too.

[Kiera]

All I can say is that with my ds, when pandas exploded 2 1/2 yrs ago, both strep titers were elevated and went in a consistent downward trend over the next 2 yrs, when in the same 2yr period he had flare-ups and remission of symptoms so there was absolutely no corelation between titer level and symptoms!! When the titers finally hit the normal range this january, his symptoms were at their worst and we just now completed his 1st ivig (with pos signs post 3days!!). I can't explain the titer thing!

[fightingmom]

All I can say is that with my ds, when pandas exploded 2 1/2 yrs ago, both strep titers were elevated and went in a consistent downward trend over the next 2 yrs, when in the same 2yr period he had flare-ups and remission of symptoms so there was absolutely no corelation between titer level and symptoms!! When the titers finally hit the normal range this january, his symptoms were at their worst and we just now completed his 1st ivig (with pos signs post 3days!!). I can't explain the titer thing!

 

Has your DS been on antibiotics since the major explosion 2 1/2 years ago? If so, maybe that was bringing titers down, despite exposure and infection?

 

Just a thought? I have no idea, lol

[Kiera]

Yes, been on antibiotics continuously. Reacts to being around strep but never swabs positive?!

[philamom]

I'm suprised a CBC wasn't ordered - I think I would request it.

 

My dd's Triglycerides jumped from 82(November)_to 227(December). Still high in March at 187. Her total cholesterol has been flagged low since September.

[fightingmom]

I'm suprised a CBC wasn't ordered - I think I would request it.

 

My dd's Triglycerides jumped from 82(November)_to 227(December). Still high in March at 187. Her total cholesterol has been flagged low since September.

 

Dr. B. ordered CBC in March, but the doctor that order the titers and the lipids panel in December didn't order CBC. Very strange right?

 

My son's total cholesterol was okay, too. Just triglycerides. What the heck could be doing that? And, that's a big jump for one month!! What the heck!Do you think it corresponds with strep? Or has to do with lyme?

[fightingmom]

Yes, been on antibiotics continuously. Reacts to being around strep but never swabs positive?!

 

Hmmm, interesting as well. My son never swabs positive either, though Dr. B. thinks strep is in the sinuses. His sinus infections absolutely correspond with the time that his titers went up between Dec - March.

 

I went and googled the antibiotics/titers thing and it seems that being on antibiotics or steroids can cause titers not to elevate, so perhaps that's the reason for the consistent shift downward after taking them so long?

[trggirl]

If you haven't found it already, look at the top pinned thread titled "helpful threads". The second post has two links where Rhonna and Buster talk about the tests.

[911RN]

I'm suprised a CBC wasn't ordered - I think I would request it.

 

My dd's Triglycerides jumped from 82(November)_to 227(December). Still high in March at 187. Her total cholesterol has been flagged low since September.

 

Dr. B. ordered CBC in March, but the doctor that order the titers and the lipids panel in December didn't order CBC. Very strange right?

 

My son's total cholesterol was okay, too. Just triglycerides. What the heck could be doing that? And, that's a big jump for one month!! What the heck!Do you think it corresponds with strep? Or has to do with lyme?

 

Triglycerides tend to run higher when someone consumes sugary foods....sodas, sweets, desserts etc

[fightingmom]

I'm suprised a CBC wasn't ordered - I think I would request it.

 

My dd's Triglycerides jumped from 82(November)_to 227(December). Still high in March at 187. Her total cholesterol has been flagged low since September.

 

Dr. B. ordered CBC in March, but the doctor that order the titers and the lipids panel in December didn't order CBC. Very strange right?

 

My son's total cholesterol was okay, too. Just triglycerides. What the heck could be doing that? And, that's a big jump for one month!! What the heck!Do you think it corresponds with strep? Or has to do with lyme?

 

Triglycerides tend to run higher when someone consumes sugary foods....sodas, sweets, desserts etc

 

Thank you! See that's the thing. I don't buy soda, candy or sweets ever! Really. He gets a trader joes granola bar that is pretty healthy for breakfast but that's the worst of it.

He drinks water all day and has a spinach smoothie with fruit at night. All organic.

[fightingmom]

If you haven't found it already, look at the top pinned thread titled "helpful threads". The second post has two links where Rhonna and Buster talk about the tests.

 

I didn't have a chance yet. Thanks for that!

[fightingmom]

Okay, so according to the posts by Buster and the others, the rise in titers is more significant than the numbers themselves. And while abx will not remove titers that are already there, they can keep antibodies from forming, ie keeping the numbers lower if infection is present, as opposed to their potential to grow higher I suppose If u had infection without abx in the picture.

 

So, this confirms that my son did have a strep infection within December- March. I believe at the time the Dec titers were done was the start of monster explosion. Symptoms were so bad during this time I often wondered if we'd make it to our dr appt with Dr.B. I think our saving grace was that I took him to the dr once because he had obvious symptoms of a sinus infection. He was treated and both his symptoms and his behavior significantly resolved. However, a week later his behavior and anger ramped up. I took him back to doc telling him he is not complaining of anything but I am Sure there is something wrong and infection had not resolved. I demanded that they check and do X-rays etc. - they thought i was nuts, but sure enough the doc said his sinuses were WORSE than the few weeks prior!

 

Then we went to Dr.B in March and he suggested that strep is likely in sinuses for both of us. I was shocked. However, then I started noticing that a lot of his patients are told the same and hoped I wasn't being fed a line...I did NOT think so, but you know those lingering thoughts in the back of your mind? Plus, as I have mentioned before on the forums, I am a "why?" girl; I must understand how something works and be able to find the link to make sense of it for me to really get it. Now, it makes sense. I am going to bring these Dec labs to our next appt, because I think that after Dr B's office got their labs back they found DNase only mildly elevated and didnt seem to give it much consideration. I also don't think my son mounts proper antibodies to most things, as I have found to be an issue in myself as well; no antibodies to vaccines, or even chicken pox despite having it in my 20's and being vaccinated again in August 2011. Maybe Lyme is playing a role in that?

 

So, in summary, this solidified a lot for me. Sealed the deal so to speak. Now, If I could figure out why this triglyceride thing is so elevated. Binge eating had been an issue for my son (in waves- and has completely resolved since abx- interesting ) - you would immediately think that could be the cause, butforthat very reason I am a nut about having only healthy foods in my house - not even juice, etc. I buy all whole food, fresh, organic, limited meat, milk/eggs from a local farm, etc.. He takes a lunch to school everyday and is picky about what I put in it, so I know he's eating it and he's pretty thin. I can't figure this out, but there may be a link I am missing.

Edited May 2, 2012 by fightingmom