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Comparative Study
. 2003 Sep;10(5):886-90.
doi: 10.1128/cdli.10.5.886-890.2003.

Group A streptococcal antibodies in subjects with or without rheumatic fever in areas with high or low incidences of rheumatic fever

Elia M Ayoub  1 , Beverly Nelson, Stanford T Shulman, Douglas J Barrett, J Douglas Campbell, George Armstrong, John Lovejoy, Gerald H Angoff, Sol Rockenmacher
Affiliations
Comparative Study

Group A streptococcal antibodies in subjects with or without rheumatic fever in areas with high or low incidences of rheumatic fever

Elia M Ayoub et al. Clin Diagn Lab Immunol. 2003 Sep.

Abstract

The levels of streptococcal antibody titers in populations with or without rheumatic fever from an area with a relatively high incidence of rheumatic fever and an area with a low incidence of this disease were compared. Streptococcal antibody titers were determined for two populations, each of which included children without rheumatic fever (nonrheumatic children) and rheumatic fever patients. The two populations were derived from two separate geographic areas, one with a high incidence of rheumatic fever (Grenada) and another with a low incidence of this disease (central Florida). The results revealed an absence of consistent differences in the geometric mean antibody titers between the nonrheumatic subjects and the rheumatic fever patients from Grenada. In the population from Grenada, the mean anti-streptolysin O and anti-DNase B titers were higher in the nonrheumatic controls (P of 0.085 and 0.029, respectively). However, the mean titer of the antibody to the group A streptococcal cell wall carbohydrate was higher in the rheumatic fever patients than in the nonrheumatic controls (P = 0.047). This finding contrasted with the finding that the means of all three streptococcal antibody titers in the patients with rheumatic fever were significantly higher than those in the nonrheumatic subjects from Florida (P = 0.01-<0.001). The reason for this paradoxical finding became evident when the streptococcal antibody titers of the nonrheumatic subjects from Grenada and Florida were compared, revealing significantly higher levels of all three antibodies in the nonrheumatic subjects from Grenada than in the nonrheumatic subjects from Florida (P < 0.001). These results suggest that nonrheumatic individuals in an area with a high incidence of rheumatic fever have inordinately elevated levels of streptococcal antibodies in serum. The presence of elevated streptococcal antibody titers in such a population, which probably reflects a high background prevalence of streptococcal infections, should be taken into consideration when evaluating the role of the group A streptococcus in nonpurulent complications of infections.

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Figures

FIG. 1.
FIG. 1.
Distribution of the streptococcal antibody titers obtained for 30 nonrheumatic individuals and 32 patients with rheumatic fever in Grenada.
FIG. 2.
FIG. 2.
Distribution of the streptococcal antibody titers obtained for 32 nonrheumatic subjects and 32 patients with rheumatic fever in Florida.
See this image and copyright information in PMC

References

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    1. Ayoub, E. M., and L. W. Wannamaker. 1962. Evaluation of the streptococcal deoxyribonuclease B and diphosphopyridine nucleotidase antibody tests in acute rheumatic fever and acute glomerulonephritis. Pediatrics 29:527-538.

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