Titres going up or down?

[cara615]

I had to start a new thread because this post got lost in the other thread.

 

In Nov ds was tested:

 

ASO Pos

Anti dNase-B - over 700

 

After 30 days of abx (amox, keflex, azithro) his tics reduced by 90%

 

Jan - mini flare (increase in frequency of low intensity vocal tics)

 

Titre re-test

 

ASO Neg

Anti dNase-B - 366 (still considered high)

 

 

Based on this I would assume his titres are going down? Because if they were rising then ASO should have been Pos because that titre rises first correct?

 

Just wondering if i need to increase the strenght of his abx. Right now he is on 75mgs/day of azithro. He is 6 and weighs 34lbs. So its an appropriate doage for his wieght.

 

thoughts?

 

 

[JoyBop]

They are definitely decreasing! That's a great sign. Its interesting that they just give you a pos or neg on the ASO. Most labs will give a number with a reference range. Keep in mind that the anti d base can remain high for a year or more, but should keep coming down at least little by little. It's also important to use the same lab for consistency.

[Hopeny]

Physician needs to ask for a quantitative test or they just say + or -. Joybop do you know the difference between the two tests?

[qannie47]

I would guess that based on your lab results that increase in abx is not necessary. Is he still flaring? That is almost more important when making the abx decision then titers. Remember, Conference feedback suggest us not chase titers. If he is 90-100% back to baseline I would not increase abx. However, if he is still struggling, I would increase abx.

[cara615]

I think his flare is resolving, but very slowly. Again, his tics are mainly 1 vocal and 1 motor and they are a little less frequent each day. Other than that he is acting normally.

 

ASO was 23.3 this time. In Nov it was just POS. different labs :-/

 

I'll give it another month and see where we are at.

 

Thanks , you made me feel better tonight

[qannie47]

One more thought. Most of the flares that my ds experienced took several weeks to completely resolve. For example, his last big flare in Sept. lasted 4 weeks and it took another 3-4 before he was 90 -100% back to baseline consistently.