More test results -- sibling carrier?

[lfran]

Hi all.

 

Just got some more test results back. My younger son (DS6 - non PANDAS) tested at 343 for ASO and 680 DNASE. He has always been asymptomatic for strep (several negative throat cultures) and PANDAS.

 

DS8 (PANDAS) is currently on a zithromax trial (250 mg per day for a month). Any thoughts on what to do about his brother? Does this sound like a carrier situation?

 

My husband and I will get our blood drawn for DNASE and ASO in a couple of days.

 

Thanks for any advice.

 

-- lfran

[JAG10]

Hi Lfran,

 

I'll take a stab at this, but-disclaimer- might not get it exactly right.

 

Your situation is somewhat similar to my two girls although both are asymptomatic of strep and I have mild pandas suspicions on the younger one. My understanding is that a carrier swabs/cultures positive repeatedly, but does not have symptoms and, I believe, does not develop the infection (which is indicated by a rise in the titers you mentioned) thus the carrier state has the reputation of being benign, which is questionable. So, it would appear that your younger son had an asymptomatic strep infection sometime in the past several months, but you can't tell exactly when because you only have one measurement and there is {no or not definitive} data on the rate of fall in titers.

 

Hopefully someone else can confirm or amend this for accuracy?

[sf_mom]

My husband's: ASO (283) and Anti-DNAse-B (680).... We treated him with antibiotics for a month and retested him: ASO (244) and Anti-DNAse-B (680). The falling titers is indicative of an active infection. We will continue to treat until the titers fall within normal range to be safe. I have e-mailed Madeleine Cunningham regarding our families titers and she stated 'it is obvious your husband shared the illness/es with your children'. Typically, they do not treat unless they are symptomatic. My husband has had some unexplained GI issues so we treated him. The strep could be any where and we were unwilling to take the risk since 'they just don't know' what the elevated titers in family members means at this point.

[airial95]

I could be wrong - but when he first dx our son, his throat culture was neg and that didn't seem to phase our ped because he said that something like 20% of carriers will also test negative on a throat culture. He pointed to a more recent impetigo infection (2 months prior) to our PANDAS outbreak as the culprit. He put him on abx to "test" his theory and he was right! 4 mo of abx has done wonders for our boy.

 

So I'm pretty sure that some carriers won't have a positive throat culture either...

[matis_mom]

Thanks for bringing this up again. I need to go get everyone's titers done and put the question to rest (hopefully?). I need to figure this out before ds goes for plasmapheresis!!!

 

Isabel