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Test ID SABP Streptococcal Antibodies Profile

Reporting Name

Streptococcal Antibodies Profile

Useful For

Demonstration of acute or recent streptococcal infection

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASO Antistrep-O Titer, S Yes Yes
ADNAS Anti-DNase B Titer, S Yes Yes

Specimen Type

Serum


Specimen Required


Container/Tube: 

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1 mL


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  7 days

Reference Values

ANTISTREP-O TITER

<5 years: ≤70 IU/mL

5-17 years: ≤640 IU/mL

≥18 years: ≤530 IU/mL

 

ANTI-DNase B TITER

<5 years: ≤250 U/mL

5-17 years: ≤375 U/mL

≥18 years: ≤300 U/mL

Day(s) and Time(s) Performed

Monday through Saturday; Continuously until 3 p.m.

CPT Code Information

86060-Antistreptolysin O, titer

86215-Deoxyribonuclease, antibody

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SABP Streptococcal Antibodies Profile In Process

 

Result ID Test Result Name Result LOINC Value
ADNAS Anti-DNase B Titer, S 5133-4
ASO Antistrep-O Titer, S 5370-2

Clinical Information

A number of bacterial antigens have been identified in cultures of group A streptococci. These extracellular products are primarily enzymatic proteins and include streptolysin O, streptokinase, hyaluronidase, deoxyribonucleases (DNases A, B, C, and D), and nicotinamide adenine nucleotidase.

 

Infections by the group A streptococci are unique because they can be followed by the serious nonpurulent complications of rheumatic fever and glomerulonephritis. Recent information suggests that rheumatic fever is associated with infection by certain rheumatogenic serotypes (M1, M3, M5, M6, M18, and M19), while glomerulonephritis follows infection by nephritogenic serotypes (M2, M12, M49, M57, M59, and M60).

 

Glomerulonephritis and rheumatic fever occur following the infection, after a period of latency following the infection, during which the patient is asymptomatic. The latency period for glomerulonephritis is approximately 10 days, and for rheumatic fever the latency period is 20 days.

Interpretation

Elevated values are consistent with an antecedent infection by group A streptococci.

 

Although the antistreptolysin O (ASO) test is quite reliable, performing the anti-DNase is justified for 2 primary reasons. First, the ASO response is not universal. Elevated ASO titers are found in the sera of about 85% of individuals with rheumatic fever; ASO titers remain normal in about 15% of individuals with the disease. The same holds true for other streptococcal antibody tests: a significant portion of individuals with normal antibody titers for 1 test will have elevated antibody titers for another test. Thus, the percentage of false-negatives can be reduced by performing 2 or more antibody tests. Second, skin infections, in contrast to throat infections, are associated with a poor ASO response. Patients with acute glomerulonephritis following skin infection (post-impetigo) have an attenuated immune response to streptolysin O. For such patients, performance of an alternative streptococcal antibody test such as anti-DNase B is recommended.

Clinical Reference

Ayoub EM, Harden E: Immune response to streptococcal antigens: diagnostic methods. In Manual of Clinical and Laboratory Immunology. Fifth edition. Edited by NR Rose, EC de Marco, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 450-457

Analytic Time

Same day/1 day

Method Name

Nephelometry