[CIS PIDD] [cis-pidd] Negative Strep Antibodies in a Patient with Recurrent Strep

[CIS-PIDD]

Colleagues:

I follow a 15yo girl who has experienced multiple "strep throats."  Most of these have been identified at the primary physician's office with a positive rapid strep antigen test.

However, anti-streptolysin O antibody and anti-DNase-B antibody have been negative.

The patient has normal IgG (817), IgA (74) and IgM (121) levels and persistently positive (>1.3) antibodies to 23 of 23 S. pneumoniae serotypes (20 of these antibodies are >3.0) 2+ years from Pneumovax.

Are the negative strep antibodies significant in this patient?

Would these results justify a trial of Ig despite the very normal pneumococcal antibody responses?

Thank you for your time.

Joe Church
Children's Hospital Los Angeles





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