Infectious Disease Consult Today

[PIK]

I'm coming back from the infectious disease doctor. She said that high ASO titers are not relevant and that they themselves don't cause symptoms. I'm confused. Very confused. And I feel like poop. I tried to get an appointment with Dr. B today but his secretaries weren't nice at all.

[peglem]

ASO titers do not cause PANDAS symptoms. They are antibodies to toxins that are excreted by strepA bacteria, and it is completely normal for them to be elevated following a strep infection. They are not diagnostic for PANS/PANDAS, but are a clue that there has been a recent strep infection. So if symptoms of PANDAS are present an elevated (or even better, rising) ASO titer gives the clinician a clue about what may be happening. I disagree that it is irrelevent, but its really a small piece of info in the context of the bigger picture, and, infact, many people with PANDAS never get elevated ASO titers at all.

[PIK]

I still don't understand. First of all, my titers were rising, from like the 600 range to the 1600 range. Secondly I have major OCD issues that are only controlled because of Anafranil, and thirdly I described my other symptoms to her (joint pain, headache, etc. etc) From what I had understood previously, the body wasn't reacting to the strep itself, but to the antibodies it produced against the strep, i.e. the ASO.

[rowingmom]

That's the IDSA for you! They really don't understand PANDAS/PANS.

[peglem]

I still don't understand. First of all, my titers were rising, from like the 600 range to the 1600 range. Secondly I have major OCD issues that are only controlled because of Anafranil, and thirdly I described my other symptoms to her (joint pain, headache, etc. etc) From what I had understood previously, the body wasn't reacting to the strep itself, but to the antibodies it produced against the strep, i.e. the ASO.

Well, rising titer is relevent, in that it indicates that the strep has not been cleared, but ASO titers are not auto-antibodies and do not cause PANDAS symptoms. They are, like I said before, actually antibodies to strep exotoxins and are used as evidence of strep in the body.

 

Its explained in this thread that has been pinned to the top of the forum- post #5 :

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