Q: The ASO titre of my son, 12 years old, is 1950 and the uric acid is 7.2. Apparently, there is no problem except some joint pain and recurrent tonsil infection. The local doctor has advised to inject penidure LA12 once after every 21 days for at least 5 years. I have started the injections but am very anxious and confused. I want to know why the ASO is so high? Is it an indication of rheumatic fever, if so what are the symptoms? What are the side effects of penidure LA12 injection for a prolonged period and is it the only treatment? Why is the uric acid so high and what is the management to control it?

A:1. Elevation of the ASO titre in isolation without any features of acute rheumatic fever does not warrant 5-year treatment with penidure. This means that as long the child does not have migratory joint swellings, cardiac involvement (normal ECHO), rash, abnormal movements or nodules under the skin the ASOT is simply a reflection of a recent Streptoccocal infection and needs only one penidure for clearance. 2. Elevation of uric acid in children is often a reflection of increased body mass and usually does not suggest gout. It needs only regular exercise and optimal weight, no drugs.