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What do strep antibodies mean?

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Can a pandas kid produce strep antibodies (dnase) without a strep infection?  During his recent flare, his dnase were 850 (upper normal is 350).  I'm 99% sure he has not had strep in a year -- because he was on abx until 6 weeks before the flare, and then we did a bunch of strep swabs and cultures (including anal) after stopping abx right through to when the flare started. Everything was negative. He had no symptoms of strep during any of this.   Unfortunately we don't have a baseline dnase number  - we didn't run bloodwork when he was feeling better. So it's possible he always runs high.  

I know pandas kids can be asymptomatic carriers of strep - but would the swabs and cultures be negative for those kids? 

We know other kids at school had strep.  I know pandas kids can flare based on exposure to strep - but would antibodies go up in those cases? 

If his flare was caused by something other than strep, would that cause the antibodies to go up?  



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Yes, strep antibodies can go up with exposure to other kids with strep.  That is what antibodies do, they are supposed to protect you against disease (think measles, mumps etc) when you are exposed.   We know that adults get their immunity reboosted when exposed to kids with childhood diseases like chicken pox.

Unfortunately for PANDAS kids, this means a flare :(

What can be done?  Maybe others can chime in....

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