Why do some not respond with elevated ASO, AntiDNase?

[Phasmid]

I need to know why some children do not have elevated Strep titers? Does anyone know the answer? Does this suggest that their bodies are not mounting an immune response to Strep, and maybe that's why they have the problem they do, in terms of PANDAS?

[peglem]

Well, either the strep are not producing the exotoxins that those titers are raised against or the body is not mounting an attack against them.

[AmySLP]

We got the answer to my daughter non-existent titers from Dr. B on Weds. You are right on that these kids with low or negative titers are b/c they are not mounting that immune response to strep. He tested strep types and found that she had non-existent immunity to 9 of those-despite havig 4 pneumoccacal vaccines which alone should have booster her immune response to strep. In adddion she's had 15+ positive rapid or cultured strep positives beginning at age 8 weeks and then 3 months of age. He assumes that I likely have the same low immune response to strep, as she should have had that protection from me, hence avoiding strep at such a young age. He did explain that there are children with the samelow immunity to strep that will never develop PANDAS, but that he feels that there is a genetic component to those kids who do. Very interestingstuff! I feel I now have a reason to explain her low/non-existent titers despite months of postitive strep tests.

 

Hope this helps....

Amy

[Phasmid]

VERY interesting! Thank you!!!

[JAG10]

This is a post by Dr. Trifiletti:

 

http://www.latitudes.org/forums/index.php?...;hl=hyperimmune

 

He breaks PANDAS down into subgroups such as hyperimmune, immune deficient, ect. although I don't know if the characteristics hold true; i.e. are there PANDAS children who are dx immune deficient yet did have elevated titers? Or PANDAS children who had the wacky sky-high titers yet also turned out have broader immune deficiency?

 

(I think) My girls are in the hyperimmune group; crazy high titers and not all that sickly besides the antineuronal antibody faucet that won't turn off.

[Phasmid]

Thanks for posting this- very informative (though it makes my head ache!)

[JAG10]

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Edited June 14, 2010 by JAG10

[Phasmid]

I agree with your final comment. However, to me, there's not much difference between 25% and 35%. All that matters to me is that there is "some percentage" of children who do not show an elevation of Strep titers. This is, indeed, a bone of contention.

[AmySLP]

Thanks for posting Dr. T's post- I am printing right now for my binder of info. My daughter is definitely type 2-immunodeficient. She had 4 prevnar vaccines and at least 15+ positive strep rapids or cultures in her 5 1/2 years and has not immune response to 9 of the 14 types that were tested. Her titers have always been nonexistent despite having had postive strep testing more than 8 times in a 6 month period in 2008/2009. We are now working with Dr. B and I feel even better hearing he and Dr. T give the same info. on how to treat kids in this "subclass" of PANDAS.

 

Thanks again for posting this,

Amy

Edited June 14, 2010 by AmySLP

[faith]

Thanks for posting Dr. T's post- I am printing right now for my binder of info. My daughter is definitely type 2-immunodeficient. She had 4 prevnar vaccines and at least 15+ positive strep rapids or cultures in her 5 1/2 years and has not immune response to 9 of the 14 types that were tested. Her tiers have always been nonexistent despite having had postive strep testing more than 8 times in a month period in 2008/2009. We are now workign with Dr. B and I feel even better hearing he and Dr. T give the same info. on this.

 

Thanks again for posting this,

Amy

 

amy,

same info on what? couldyou clarify? thanks

Faith

[AmySLP]

Thanks for posting Dr. T's post- I am printing right now for my binder of info. My daughter is definitely type 2-immunodeficient. She had 4 prevnar vaccines and at least 15+ positive strep rapids or cultures in her 5 1/2 years and has not immune response to 9 of the 14 types that were tested. Her tiers have always been nonexistent despite having had postive strep testing more than 8 times in a month period in 2008/2009. We are now workign with Dr. B and I feel even better hearing he and Dr. T give the same info. on this.

 

Thanks again for posting this,

Amy

 

amy,

same info on what? couldyou clarify? thanks

Faith

 

 

I edited the post...hope that clarifies things!

[faith]

amy,

are you saying you feel Dr. B. gave you the same info that you are now reading that Dr. T. put out? is that what you mean?

[AmySLP]

yes, It seems that they are both on the same page in regard to treating PANDAS in children with Underactive Immune System/those who are immunodeficent on pneumococcal serotype testing with no rise in titers.