AntiDNase B for family 5440-7680

[Iowadawn]

Hi all!

 

I have emails into Dr. K and Dr. C regarding these results. Go ahead and chime in.

Ds11 PANDAS (in hindsight, an early onset case) IVIG#1 Oct 09, IVIG #2 scheduled for This Wed/Thurs w/ Dr. K.

Dd15 PANDAS adol variant dx Dec09

 

Now for the titer results. I insisted that the ASO/ADB titers be taken on each family member back in Dec. despite negative throat cultures. Our son started taking high dose Augmentin post IVIG #1 and has been on that since Oct. The other four of us had a month of high dose Augmentin starting in Dec. Actually, dd15 had about 6 weeks.

 

Help me out doc & others:

pandasDS11: preIVIG#1: 780/1360 12/09: 378/580 3/09: 378/5440

pandasDD15 12/09: 752/5400 3/09: 756/ (probably sent to the moon it's so high--it was the first sent in! Pending, I'm told.)

DD13 12/09: neg/188 3/09: neg/960

Mom 12/09: 756/1920 3/09: 756/5440 (has psoriasis. Could this be the problem??)

Dad 12/09: 189/1920 3/09: 189/5440

 

DD15 symptoms went away on abx. They have started to creep back in. Dr. K put her back on Augmentin.

 

I am aware the ADB lags the ASO in rise & fall. Will we be bringing our son back home to a strep factory again? Does our son's results indicate that Augmentin is not cutting it w/ this strain of strep??

 

I need insight.

 

Dawn

[Dr_Rosario_Trifiletti]

Hi all!

 

I have emails into Dr. K and Dr. C regarding these results. Go ahead and chime in.

Ds11 PANDAS (in hindsight, an early onset case) IVIG#1 Oct 09, IVIG #2 scheduled for This Wed/Thurs w/ Dr. K.

Dd15 PANDAS adol variant dx Dec09

 

Now for the titer results. I insisted that the ASO/ADB titers be taken on each family member back in Dec. despite negative throat cultures. Our son started taking high dose Augmentin post IVIG #1 and has been on that since Oct. The other four of us had a month of high dose Augmentin starting in Dec. Actually, dd15 had about 6 weeks.

 

Help me out doc & others:

pandasDS11: preIVIG#1: 780/1360 12/09: 378/580 3/09: 378/5440

pandasDD15 12/09: 752/5400 3/09: 756/ (probably sent to the moon it's so high--it was the first sent in! Pending, I'm told.)

DD13 12/09: neg/188 3/09: neg/960

Mom 12/09: 756/1920 3/09: 756/5440 (has psoriasis. Could this be the problem??)

Dad 12/09: 189/1920 3/09: 189/5440

 

DD15 symptoms went away on abx. They have started to creep back in. Dr. K put her back on Augmentin.

 

I am aware the ADB lags the ASO in rise & fall. Will we be bringing our son back home to a strep factory again? Does our son's results indicate that Augmentin is not cutting it w/ this strain of strep??

 

I need insight.

 

Dawn

 

This is an amazing and unusual case for the disparity between ASO and anti-DNAase B.

 

Although these are the highest anti-DNAase B values I've ever seen, remember, most labs report what I call "TILT" values (from the old slot machines), i.e >1:2720 or something like that ...

 

I'm guessing that this is not Group A strep, perhaps C or G ... (C and G have SO but levels of DB may be relatively higher)

 

 

There is also something called anti-streptolysin S which I will not abbreviate for obvious reasons. LOL

 

Dr. T

 

 

P.S. I'd be happy to talk with you further offline. PM me with contact information if you wish!

[Iowadawn]

These were sent to Mayo because the local lab in Des Moines maxes out at >1360.

 

I will PM you. Thanks! Dawn

[dee45]

My sons also just came back >1360 so what does this mean if on antibiotics when titers drawn?? I am so confused.

 

Deanna

[7upMom]

Dawn,

let us know when you find out the cause of this. Very interesting, and I'm sure very frustrating for you and family!! We are going to be taking your direction on family titers, and scheduling a family check also. I think you prove this is an important factor

[7upMom]

Also- does insurance pay for the whole family to be tested for strep titers

[Iowadawn]

We have never had an insurance issue with having the titers checked for the entire family. I don't know how they could with the results we have gotten!! We are thinking some skin issues with dh & myself may actually be strep of some sort. Off to a dermatologist, I think. Trying to get some insight on PANDAS implications, etc. Dawn