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

[CIS-PIDD]

Joe,
It sounds like there is some uncertainty about the strep throats. Rapid
strep tests that incubate for longer than the appropriate time will all be
positive. You might just try penicillin (or amoxicillin) prophylaxis to see
if it makes a difference with these recurrent symptoms.
Richard Wasserman
Dallas

On Wed, Oct 18, 2017 at 8:19 PM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
wrote:

> 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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-- 
Richard L. Wasserman, MD, PhD
Allergy Partners of North Texas
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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