What Causes Joint Swelling, Pain In Wrists, Fingers, Elbows, Stiff Neck , Spine Pain And Memory Loss Inspite Of Having High ASO Titres

Brief Answer: Strept Infection is a possibility Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. The increase in ASO Titres indicates an exposure to Strept. However, as many people are exposed to these bacteria and remain asymptomatic, the mere presence of ASO does not indicate disease. In fact , it can be raised due to some sub clinical infection in the past. This titre has a significance only if : 1. Highly Elevated (>200) 2. If if a rise in titre can be demonstrated in paired blood samples taken days apart. I would like to know following things : 1. Any history of fever in the recent past? 2. Any past history of Tuberculosis or Liver disease? 3. Any history of Alcohol consumption. False positives rise in ASO Titres can result from liver disease and tuberculosis. I don't think there is any problem in giving him a course of antibiotic. Now, if we talk about your scenario , a prophylactic treatment is usually indicated in contacts of the patient under following circumstances : 1. Individuals with history of rheumatic fever 2. Individuals who develop acute pharyngitis during an outbreak of acute rheumatic fever or acute poststreptococcal glomerulonephritis. 3. Spread of among several family members. In case you qualify any of the above , or you are having any symptoms of Strept infection you should take prophylactic antibiotic treatment. This is my personal opinion based on details available here. If you still have any query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD

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Brief Answer: Rheumatic fever is a possibility. Also Vasculitis Detailed Answer: Welcome Again. I told you that a positive ASO titre means a recent or past infection with Strep. You have joint pains that jumps around (we call it migratory polyarthritis) , that can be a symptom of Rheumatic Fever. Yes , your doctor is right , you should get a Echocardiography of the heart to see for any evidence of Rheumatic Heart Disease. Your ANA is positive , then we should do work up to rule out Vasculitis Syndromes. Esophageal Dysmotility problems are frequently seen in Systemic Sclerosis. I suppose your doctor must have ruled out that. Joint Pains , Eye involvement , ANA positivity - With these three things we suspect Vasculitis Syndromes. I would advise you to get a complete work up done once to be sure of the diagnosis , so that once it is made , you can be treated accordingly , and your problems can be resolved. Following is the complete work up list (Omit the investigations that you have got already) : 1. Hemogram with ESR 2. C-Reactive Protein 3. Kidney Function Test 4. Liver Function Test 5. Chest Xray 6. Auto antibody Panel (including XXXXXXX , HLA B26) 7. Echocardiography I know it is a long panel of test , but a perfect diagnosis is required to help you reduce your sufferings. Discuss with your doctor about my opinion. Now regarding Strept infection , it can range from asymptomatic to symptomatic infection. With High ASO Titres , you should take antibiotics as have been advised to you. You can be contagious , but when you have been started on antibiotics , the infection would get treated with in 5 days. Usually , most doctors give a course for 5-10 days. No need as such to give antibiotics to your family for prophylaxis. If any one shows symptoms , he/she should be tested and treated. I understand you are suffering a lot due to your illness , but i am sure , with these investigations , a conclusion can be drawn about the diagnosis. This is my best advise for you based on details available. If you have any further query , please feel free to ask me.

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