Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever

Background: Acute rheumatic fever and rheumatic heart disease are the significant non-suppurative late sequelae of group A beta hemolytic streptococcal infection. Anti-streptolysin O titer (ASOT) is a streptococcal antibody test that is used for the diagnosis of infections and is particularly useful...

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Main Authors: Mohamed S. Eid, Fatma Al Zahraa Mostafa, Hend Hamed Tamim, Mohamed Elberry, Shaimaa Sayed
Format: Article
Language:English
Published: Cairo University, Faculty of Medicine, Department of Pediatrics 2022-01-01
Series:Pediatric Sciences Journal
Subjects:
Online Access:https://cupsj.journals.ekb.eg/article_210820_ca89818dd066f964bb32376a93c7de43.pdf
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author Mohamed S. Eid
Fatma Al Zahraa Mostafa
Hend Hamed Tamim
Mohamed Elberry
Shaimaa Sayed
author_facet Mohamed S. Eid
Fatma Al Zahraa Mostafa
Hend Hamed Tamim
Mohamed Elberry
Shaimaa Sayed
author_sort Mohamed S. Eid
collection DOAJ
description Background: Acute rheumatic fever and rheumatic heart disease are the significant non-suppurative late sequelae of group A beta hemolytic streptococcal infection. Anti-streptolysin O titer (ASOT) is a streptococcal antibody test that is used for the diagnosis of infections and is particularly useful in the diagnosis of acute rheumatic fever. Aim of the work: To compare ASOT values in normal children to those with rheumatic fever and children with recurrent tonsillitis, and to evaluate its relationship with seasonal variations. Methods: A case-control study conducted on 300 children; 100 children with rheumatic fever, 100 with recurrent tonsillitis and 100 apparently healthy children as a control group. Children were subjected to history taking, echocardiography study and blood specimens for complete blood count, erythrocyte sedimentation rate, C reactive protein and ASOT were assessed using immunoturbidimetric assay tested by Cobas e501/502 (Roche). Human anti-streptolysin O antibodies (any type) agglutinate with latex particles coated with streptolysin O antigens. Results: Mean and SD of age in each group was 10.2±3 years for rheumatic fever group, 7.3± 3.8years for recurrent tonsillitis group and 5.4±2.4 years for control group. Rheumatic fever group included 49 males and 51 females, recurrent tonsillitis group included 58 males and 42 females, control group included 63 males and 37 females. ASOT ranged between 261-860 (mean± SD= 475.1±214.2), 210-813 (mean± SD= 257.6±56.4) and 65- 820 (mean± SD= 158.8± 105.4) among those with rheumatic fever, tonsillitis and control group respectively (p=0.001). ASOT level between 400-800 IU/ml were common among patients with rheumatic fever and levels between 200-400 IU/ml were common with recurrent tonsillitis (p < 0.001) with lack of diagnostic cut-off. Conclusion: ASOT levels are higher in rheumatic fever patients compared with recurrent tonsillitis and normal children. There is lack of diagnostic cut-off of ASOT, hence the value of ASOT is only within scoring system to avoid over or under diagnosis of acute rheumatic fever. An isolated high ASOT is not sufficient to diagnose or rule out acute rheumatic fever.
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spelling doaj.art-89726da2896b4f0d8b680f3afe58fa052023-07-02T07:41:14ZengCairo University, Faculty of Medicine, Department of PediatricsPediatric Sciences Journal2805-279X2682-39852022-01-0121546110.21608/cupsj.2021.106125.1034Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic FeverMohamed S. Eid0https://orcid.org/0000-0003-4245-7482Fatma Al Zahraa Mostafa1Hend Hamed Tamim2Mohamed Elberry3Shaimaa Sayed4https://orcid.org/0000-0002-9009-165XPediatrics Department, Faculty of Medicine, Cairo University, EgyptPediatrics Department, Faculty of Medicine, Cairo University, EgyptClinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, EgyptPediatrics Department, Faculty of Medicine, Cairo University, EgyptPediatrics Department, Faculty of Medicine, Cairo University, EgyptBackground: Acute rheumatic fever and rheumatic heart disease are the significant non-suppurative late sequelae of group A beta hemolytic streptococcal infection. Anti-streptolysin O titer (ASOT) is a streptococcal antibody test that is used for the diagnosis of infections and is particularly useful in the diagnosis of acute rheumatic fever. Aim of the work: To compare ASOT values in normal children to those with rheumatic fever and children with recurrent tonsillitis, and to evaluate its relationship with seasonal variations. Methods: A case-control study conducted on 300 children; 100 children with rheumatic fever, 100 with recurrent tonsillitis and 100 apparently healthy children as a control group. Children were subjected to history taking, echocardiography study and blood specimens for complete blood count, erythrocyte sedimentation rate, C reactive protein and ASOT were assessed using immunoturbidimetric assay tested by Cobas e501/502 (Roche). Human anti-streptolysin O antibodies (any type) agglutinate with latex particles coated with streptolysin O antigens. Results: Mean and SD of age in each group was 10.2±3 years for rheumatic fever group, 7.3± 3.8years for recurrent tonsillitis group and 5.4±2.4 years for control group. Rheumatic fever group included 49 males and 51 females, recurrent tonsillitis group included 58 males and 42 females, control group included 63 males and 37 females. ASOT ranged between 261-860 (mean± SD= 475.1±214.2), 210-813 (mean± SD= 257.6±56.4) and 65- 820 (mean± SD= 158.8± 105.4) among those with rheumatic fever, tonsillitis and control group respectively (p=0.001). ASOT level between 400-800 IU/ml were common among patients with rheumatic fever and levels between 200-400 IU/ml were common with recurrent tonsillitis (p < 0.001) with lack of diagnostic cut-off. Conclusion: ASOT levels are higher in rheumatic fever patients compared with recurrent tonsillitis and normal children. There is lack of diagnostic cut-off of ASOT, hence the value of ASOT is only within scoring system to avoid over or under diagnosis of acute rheumatic fever. An isolated high ASOT is not sufficient to diagnose or rule out acute rheumatic fever. https://cupsj.journals.ekb.eg/article_210820_ca89818dd066f964bb32376a93c7de43.pdfacute rheumatic feveranti-streptolysin o titerrecurrent tonsillitis
spellingShingle Mohamed S. Eid
Fatma Al Zahraa Mostafa
Hend Hamed Tamim
Mohamed Elberry
Shaimaa Sayed
Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
Pediatric Sciences Journal
acute rheumatic fever
anti-streptolysin o titer
recurrent tonsillitis
title Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
title_full Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
title_fullStr Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
title_full_unstemmed Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
title_short Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever
title_sort revisiting the value of anti streptolysin o titer in children with rheumatic fever
topic acute rheumatic fever
anti-streptolysin o titer
recurrent tonsillitis
url https://cupsj.journals.ekb.eg/article_210820_ca89818dd066f964bb32376a93c7de43.pdf
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