Q: My child is 15 years old and his ESR test revealed a level of 46 mm/hr. Is this normal? The CRP is 37 mg/dl and the ASLO titre is 200. Do these tests indicate rheumatoid arthritis?

A:The clinical details of your child are not available and interpretation of lab results in isolation is not always correct. The ESR as stated is high, and the CRP positive, which suggests inflammation any where in the body. An ASLO titre of 200 is again not interpretable in isolation and only suggests that the patient has responded to a streptococcal infection in the recent past. The mere presence of ASLO in the blood test does not suggest acute rheumatic fever. Rheumatoid arthritis is an autoimmune disease that affects the small joints of the hands in young women and will not have a positive ASLO test.