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Old 08-25-2006, 11:36 AM   #1
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Elevated ASO Titer, no strep symptoms

I am 44 years old and had arthritis panel bloodwork done a month ago due to sore joints/fatigue. Everything came back normal except the ASO titer. It was at 651.2 UI/mL. The nurse called me and told me to take amoxicillan for 10 days and come back in 2 weeks for a repeat bloodtest. I did, and then the ASO titer came back at 600.5 IU/mL. I went to see my doc and she said she didn't know why I had sore joints and fatigue, that she would refer me to a Rheumatologist. She said she wouldn't worry about the ASO titer, that since I get strep throat at least once a year, that my level of antibodies is probably just high. I am concerned with this answer, and wonder if anyone knows anything about this? The funny thing is, I have not been sick nor have had strep throat this year at all thus far.

 
Old 10-10-2006, 08:35 AM   #2
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Re: Elevated ASO Titer, no strep symptoms

I would try to see an Infectious Disease doctor if possible. I had exactly the same problem three years ago, let it continue, and ended up with pericarditis and a lung abscess. The pericarditis came from rheumatic fever from strep (I even had my tonsils out 5 years ago). I then got a lung abscess in the hospital from the pain meds they gave me (I aspirated into my lung because I was over medicated). Once a year strep does not cause levels that high. You need to get on long-term antibiotics before something happens to your heart.
There are still several doctors that refuse to believe that in this day and age an adult can get rheumatic fever. I had a rheum md and an ID md both tell me it was something else(but they couldn't tell me what). Fortunately, my PCP and cardiologist treated it correctly.
Good luck!

 
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Old 11-03-2006, 02:20 PM   #3
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Re: Elevated ASO Titer, no strep symptoms

Thank you so much for your reply. I was beginning to think I was the only one who ever had a really high ASO titer! I will try to see an infectious disease doc. Rheumatic fever is what I am afraid of, especially since I am so sore all over. I do have an appointment with a Rheumatologist on Dec. 1, but I will try to get the other appointment as well. I am glad you are doing better now.

 
Old 09-27-2007, 05:05 PM   #4
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Re: Elevated ASO Titer, no strep symptoms

I am 50 with similar symptoms. Migrating joint pain. Started in left knee with no known cause. Moved from joint to joint for months. Frequent fatigue. Then in June several joints at a time were hurting. Doctor ran full blood work. Everything normal except ASO which was 825. He said I had strep in my joints. After 10 days of 2000mg. a day of Pennicillin, and two weeks of waiting, ASO was 707. A week later symptoms worsened dramatically. Low grade fever about half the time. Severe fatigue; couldn't even sweep the floor without braking into a sweat. Severe joint pain. Burning pain in wrists and elbows felt almost like frost-bite. Bed-ridden for nearly two weeks. Motrin under 800mg was inaffective. ASO was up to 818. Two more weeks on Penn. and a month waiting to see Rheumatologist. He says it's not Rheumatic Fever because I'm too old, it's too rare, and my heart is not affected. He did call it Post-Strep Reactive Arthritis. He is recommending long acting Pennicillin shots once a month. It has been another month waiting for a referral to an Infectious Disease Doctor. ASO is currently 727.

 
Old 09-30-2007, 03:31 AM   #5
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Re: Elevated ASO Titer, no strep symptoms

Hey everybody.

I've have an elevated asot for at least a year and a half-- unfortunately, I think it's the cause of my MS-like neuropathy. By the way, an ASOT that is consistently that high is indicative of an autoimmune process.

I originally had a todd count of 650 (1.5 years ago), but am now down to 330. It seems to plateau every time I'm off of antibiotics. Amoxicillin 500 qid seemed to suppress my autoimmunity for about 6 months, but currently no longer works.

I would take stronger drugs if I could (but unfortunately have IBD too). You really must insist on something stronger than penicillin or amoxicillin-- despite what the idiot doctors say, Strep can linger, and isn't always killed by 10 days of antibiotics. When my stomach heals up, I'm going to try a cephalosporin/macrolide combination.

I've also been resourceful and found a nutraceutical compound that seems to lessen my autoimmunity-- n-acetyl glucosamine. Since starting, my ASOT count has been decreasing, whereas before it had simply plateaued.

Oh yeah, good luck.

 
Old 01-28-2008, 08:21 AM   #6
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Re: Elevated ASO Titer, no strep symptoms

Hi My daughter has the same symptoms... she is 12 I am going crazy... her blood work shows her positive for strep A but when she went in for the throat culture it came back neg. But.... her ASO were at 800 I dont even have a clue what that number means... Please give me some insight..

 
Old 01-28-2008, 09:48 PM   #7
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Re: Elevated ASO Titer, no strep symptoms

Asot = AntiStreptolysin O Titer

Streptolysin O is an immunogenic toxin produced by strep; it's known to cause immune system malfunction, hyperactivity, and autoimmunity.

800 is very high-- a normal person will generally only have 100 or 200-- some exceptions do exist however (occasional strong antibody reaction). If she has symptoms of rheumatic fever or autoimmunity, the number is a dead give away, on the other hand, however.

Strep can also grow in the nose, or in hidden folds in the tonsils. It is also known to live inside of epithelial cells, out of reach from Beta lactam (penicillin, amoxicillin) antibiotics and the immune system. There is also such a thing as a post-treatment carrier state-- since antibiotics hardly ever eradicate every single bacterium (penicillins are also unable to eradicate the carrier state) See if you can get a cephalosporin or macrolide antibiotic.

Good luck

Last edited by steerpike; 01-28-2008 at 09:49 PM.

 
Old 03-17-2008, 07:04 PM   #8
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Re: Elevated ASO Titer, no strep symptoms

Hi, I'm very curious to learn more about how Strep could be related to autoimmunity. I'm a 38year old male. For over 15 years, I've had frequent bouts of recurrent sore throats (1-3 per year) and seem to get sick frequently and easily. During these times, some throat cultures detected Strep, however not all the time. Last summer I noticed my mouth was really dry at times, particularly while exercising. In September I had a severe bilateral swelling of both my Parotid and Submandubular salivary glands. My mouth was severely dry and my ENT suspected Sjogren's Syndrome, however only treated me for an infection. The swelling went down after taking antibiotics, however the mouth dryness lingered. I went to the doctor three weeks ago and mentioned to my general physician that my ENT told me last fall about the possibility my dry mouth could be a sign of Sjogren's. Since I've still been having a slightly dry mouth, my GP ran some additional blood tests. Here are the results of the two lab results that were out of range...

RA Latex Turbid 124.1 IU/mL (0.0-13.9 normal range)
Antistreptolysin O Ab 515.9 iU/mL (0.0-200 normal range)

I've researched online but have found very little about these two being related until I reach the previous posting. I went to a Rheumatologist today, but she didn't say that the two issues could be related. I had additional blood work ordered and she prescribed Plaquenil 200mg for possible RA inflammation, SalaGEN 5mg up to three times a day for saliva production, and doxycyline hyclate 100mg antibiotic for 30 days. Does anyone know if this antibiotic is in the cephalosporin or macrolide class of drugs? Do you have any other advice on how to test to determine if the high ASO titer has caused me to develop Sjogren's Syndrome and possibly RA (autoimmunity diseases)?

 
Old 03-24-2008, 03:41 PM   #9
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Re: Elevated ASO Titer, no strep symptoms

Hi, I haven't heard of strep being linked to Sjogrens-- at least not yet.

Most of the studies I've read have linked it to rheumatic fever, joint pain, arthritis, carditis, nephritis, neuropathy, encephalomyelitis, OCD, PANDAS, and etc.

But bacteria evolve new virulence factors all the time-- who's to say that the strep you have isn't producing a novel superantigen. MRSA and Flesh Eating Disease didn't exist 30 years ago, so why should garden-variety Strep stay the same? And why should Strep behave identically for every patient?

At the very least, I'm sure that the unresolved strep infections aren't doing anything for your symptoms.

Doxycycline isn't a macrolide or cephalosporin-- it's a tetracycline-based drug. I think rheumatologists prescribe it for its anti-inflammatory effects. Unfortunately Strep is mostly immune to Doxy, or Minocycline.

Azithromycin is a macrolide sometimes prescribed by Rheumatologists-- it also has anti-inflammatory effects independent of its antibiotic activity. But on the positive end, it kills strep-- even intracellular L-forms!

I have a static ASOT at 350 (down from 680 after 5-months of Amoxicillin) and an unidentifiable demyelinating disease. My symptoms and ASOT always decrease when antibiotics are administered. My first episode occurred after a severe 4-month bout with Strep-- and attacks used to be accompanied by a severe sore throat.

I'm currently waiting until my stomach is better to take the 3-months worth of
of macrolides (Azithromycin) and cephalosporins (Cefuroxime) I've managed to stockpile. I'll let you know how my experiment goes. I'm hoping that once my ASOT is down to zero my autoimmunity will finally resolve. Or that my Infectious Diseases doctor will take note.

 
Old 04-10-2008, 05:03 PM   #10
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Re: Elevated ASO Titer, no strep symptoms

Hi My Daughter is 16 has been fighting the asot for about 4 years really just figured it all out last sept. 07. she was on an 4 diferent meds and had toncils out in feb. hasent had a possitive throat culture in years, but guess what counts have risen again back up to 714 4 weeks ago ( they had gone down too 445 high count was 800), being retested tomorrow and i will bet anybody there back up even higher. Shes worse and worse everyday seeing a rum dr. but wondering if she should see and infectious. shes missed so much school cause she's so sore and they keep trying to tell me thats shes at that age she might be depressed because she's always so tired. How many times do me and her have to tell them she's not!!!!!!! she dosen't feel good can hardly move at times. Helpppppp. even told me not to go to hospital they other day cause she couldnt move, they said they would just look at me like i was nuts.

 
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Old 07-31-2008, 08:46 AM   #11
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Re: Elevated ASO Titer, no strep symptoms

One thing I have not seen mentioned is glomerulonephritis. Elevated ASO titers can indicate this also. Please ask your doctors about this possibility.

Has anyone tried going to a Natural Health care doctor? perhaps they can look at things differently than the medical doctors. Often a more natural doctor will look at what is causing the symptoms, rather than giving a medication to make the symptom go away. Just a suggestion.

Last edited by lovingwhatis; 07-31-2008 at 08:55 AM. Reason: forgot to include something

 
Old 07-31-2008, 12:54 PM   #12
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Re: Elevated ASO Titer, no strep symptoms

lovingwhatis,

I know what you mean by doctors sometimes looking only at the symptoms rather than the cause of symptoms, but I encourage you to NOT go to a naturopathic doctor because you think they'll somehow "do a better job".

General practitioners, as a result of the very broad training they HAVE to get, often aren't familiar with the management or the significance of certain conditions which tend to be more on the rare side. Additionally, they tend to see many more patients who are relatively healthy. Internists, on the other hand, usually deal with patients who are either very ill, or at least have something which needs diagnosis and management. As a result, we are very well trained to find the CAUSE of symptoms rather than just treating them.

A great example that is seen all the time is the 74 year old guy who shows up with iron deficiency anemia. Many family doctors will see that and start the man on iron. The question remains, WHY does this person have iron deficiency? The answer often is chronic small volume blood loss, with the most sinister thing you rule out being colon cancer. So again, a good family doctor, and most internists think this way.

Back to the ASO titre. An increased ASO titer does not "indicate glomerulonephritis". All the titer indicates is recent exposure to Group A streptococcus.

In certain individuals who are exposed to Group A strep and not treated develop a secondary immune response to the bug. The most famous of these immune responses is rheumatic fever which consists of (subcutaneous nodules, pancarditis esp valvulitis, migrating arthralgias/arthritis, sydenham's chorea and erythema marginatum), but other wayward immune responses include a nodular rash called erythema nodosum as well as post-streptococcal glomerulonephritis (which is NOT part of rheumatic fever).

When making the diagnosis of one of the immune complications of Streptococcus, the ASO titer is helpful only in proving recent exposure to GAS. A lot of the time you don't have the luxury of this, so you must instead go on the clinicall picture (i.e. the person had a sore throat and fever 10 days ago).

One other thing that's important: usually the immune complications of streptococcus happen minimum about a week to 10 days after the infection. Also, it is important to note that the ASO titer may stay positive for some time after the Strep infection is actually gone.

 
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Old 07-31-2008, 12:57 PM   #13
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Re: Elevated ASO Titer, no strep symptoms

Oh, by the way...when I meant not to go to a naturopathic doctor, I didn't mean to say NEVER go to one. I meant don't just go to a naturopathic doctor because you think one conventional doctor is only treating your symptoms rather than the cause. It's important for many treatable conditions which are out of the realm of a family doctor's domain, to at least be seen by a specialist.

I guess it's kinda analogous to the old saying, "Don't throw the baby out with the bathwater."

 
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