Q: My 8 years old son old has elevated ASO 500+. His doctor is giving him Pencom injection every 21st day that as he is assuming that my son is suffering from rheumatic arthritis. My son does not complain of any serious pain in joints. How can we be sure that he has rheumatic arthritis? What else can lead to elevated ASO levels?

A:An elevated ASO titre only means that he has been exposed to streptococcal infection to which almost all kids are exposed at some time and in due course the titres are expected to fall. Purely an elevation in ASO does not at all mean that he has rheumatic arthritis.

You have not mentioned what prompted the doctor to ask for the test or what are the child's symptoms.Whether the child has rheumatic arthritis or not is dependent on the total clinical picture not on elevated ASO and an elevated ASO by itself is not enough reason to put the child on long term penicillin.