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intercellular strep


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I have seen intercellular strep mentioned often here. i've tried to google it but i can't get a good handle on what/how that occurs. my son has had high aso and anti-dnase. they've come down but are still high. our pediatrician cannot imagine that he'd still have strep - where could it be? he's never had a bone break, never had dental work, never had invasive procedures -but agrees those titers should not still be so high.

 

does anyone have good info that explains intercellular strep?

 

if a PANDAS kid reacts to other viruses, is it a skewed immune response in general or does the immune system release the offending antibodies even though the infection isn't strep?

 

 

thanks,

Kathy

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I think the theory is that strep is the first "trigger" for this, and then after that it seems any immune response can cause PANDAS symptoms, but not as devasating as strep.

 

http://ajp.psychiatryonline.org/cgi/reprint/155/2/264

 

From Swedo's paper, "Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections: Clinical Description of the First 50 Cases"

page 7:

 

The possibility that pathogens other than GABHS

can induce neuropsychiatric symptoms is suggested by

the presence of non-GABHS-related exacerbations in

the children with PANDAS, as has been reported for

Sydenham’s chorea (23). It is postulated that GABHS

needs to be the initial autoimmunity-inciting event but

that subsequent symptom exacerbations can be triggered

by viruses, other bacteria, or noninfectious immunologic

responses.

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There are at least a couple of parents on this forum who have had kids with neg throat cultures (including diana pohlman's son) but MRI's have revealed sinus infections. So, that is one place strep can hide out, in the sinuses. Diana's son dramatically improved once they started azith for the sinus infection.

 

Is your son on abs? which one and what dose? Ed Kaplan (who strep expert) has an article that said that Azith. was the best ab for getting intracellular strep.

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