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What does elevated ASO indicate?

Q: My five years old daughter has complained knee pain in both knees two years back. She complains knee pain approximately once in every 8-10 days. Recently, ASO titre – 400 was found. What does it indicate?

A:The ASO being elevated and the young child complaining of knee pain episodically over the last two years are unrelated as the disease called acute rheumatic fever where the joints are inflamed and painful and the ASO elevated is a short lived condition where the joint pain and swelling is severe, migrates from one large joint to the next, and does not persist for more than 6 weeks. Thus the ASO elevation in your daughter’s case simply reflects an exposure to the bacteria called streptococcus, which is a cause for a sore throat but not acute rheumatic fever. She would need evaluation by a paediatric rheumatologist to pick up the reason for the joint pains.

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