How to use antistreptolysin O titre.
Group A streptococcus (GAS) is the cause of a wide range of acute suppurative and, following a latent period, non-suppurative diseases such as rheumatic fever and poststreptococcal glomerulonephritis. Diagnosis of the latter group requires evidence of preceding GAS infection. The bacteria produce a range of extracellular antigens, including streptolysin O, which induce an antibody response in the host. A rise in antistreptolysin O titre (ASOT) is indicative of preceding GAS infection. In clinical practice, often only a single ASOT measurement is available and its timing in relation to a possible GAS infection is unknown. Interpretation of the result in this context is liable to misdiagnosis. In order to optimise diagnosis of preceding GAS infection, at least two sequential ASOT measurements, together with simultaneous assay for anti-DNase B, a second antistreptococcal antibody, is recommended.
Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK.
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Sen
Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK.
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Ramanan
D000907:Antibodies, Bacterial; D000989:Antistreptolysin / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D002648:Child; D006801:Humans; D013290:Streptococcal Infections / Q000175:diagnosis*; D013297:Streptococcus pyogenes / Q000276:immunology*; D013301:Streptolysins / Q000276:immunology
D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D013301:Streptolysins; C025964:streptolysin O; D000989:Antistreptolysin
General Paediatrics; Infectious Diseases; Musculo-Skeletal; Rheumatology