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Elevated ASOT in child with chronic headache
My child has had a headache for months folowing a sore throat, ear ache, cold and then a head injury and mild concussion.  The Doctor said it was sinusitus. Blood tests were fine except for an ASOT of >400.  This was treated by antibiotics. A later CAT scan showed maxillary sinusitus but the ENT specialist said this did not explain his frontal headache. His ASOT is now >900. He is sick and tired and I am worried. Any clues?
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Hi there!
It is difficult to confirm anything without external examination.ASO is an antibody which is generated in response to infection by Group A streptococci. Diseases which cause high ASO titer are rheumatic fever, scarlet fever, erysipelas, acute post streptococcal glomerulonephritis.In scarlet fever there is fever, abdominal pain, sore throat but there is a classical sandpapery feel rash which helps in its diagnosis. Rheumatic fever is characterized by appearance of a rash, skin nodules, joint pains, fever, heart problem, and involuntary movements .In acute posts streptococcal glomerulonephritis there is edema, hematuria, and hypertension with or without oliguria .Hypertension may cause severe headache. Get his blood pressure checked. How severe was the concussion? Your child needs reevaluation. A complete clinical check up to see if any abnormal sign has been missed and investigations like complete blood counts,ESR,CT scan brain may be needed. These possibilities are based on the information provided by you. A complete checkup and investigations are essential for correct diagnosis. Do write to us again.
Take care and best luck!
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Thank you very much for replying and explaining the test and possible causes.  The ASOT has finally come down, back to ~400.  We have now seen a nuerologist and had an MRI, with little result other than a 7mm spot - a T2 signal abnormality.  He continues to have a headache, earaches, puffy eyes and feels generally unwell.  All other blood test are normal. He has grown heaps since he has been unwell and has put on weight. We are now going to see a paediatrician and will also have a repeat MRI in six months. We still don't know what is wrong.
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Get a second opinion from a PEDIATRIC neurologist at a Children's Hospital.
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We did see a Paediatric nuerologist whom works at a Children's hospital.  We await the second MRI.  Meanwhile we have seen a paediatrician and had general blood tests, including for allergies. All OK.  He has had elevated fasting blood sugar levels, tested at home. A test of SHBG was low. He is taking propanalol and his eyes seem less puffy.  I wonder if it is some endocrine disorder. Increased weight, height, numerous stretch marks on thighs and upper arms and no energy.  Headache persists. Thanks to Arti and Crazy in the Head for replying.
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