{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:52:00Z","timestamp":1756993920746},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2012,2,9]],"date-time":"2012-02-09T00:00:00Z","timestamp":1328745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Over diagnosis of acute rheumatic fever (ARF) based on a raised antistreptolysin O titer (ASOT) is not uncommon in endemic areas. In this study, 660 children (aged 9.2 \u00b11.7 years) were recruited consecutively and classified as: G1 (control group, n=200 healthy children), G2 (n=20 with ARF 1st attack), G3 (n=40 with recurrent ARF), G4 (n=100 with rheumatic heart disease (RHD) on long acting penicillin (LAP)), G5 (n=100 with acute follicular tonsillitis), and G6 (n=200 healthy children with history of repeated follicular tonsillitis more than three times a year). Serum ASOT was measured by latex agglutination. Upper limit of normal (ULN) ASOT (80th percentile) was 400 IU in G1, 200 IU in G4, and 1600 IU in G6. Significantly high levels were seen in ARF 1st attack when compared to groups 1 and 5 (P&lt;0.001 and P&lt;0.05, respectively). ASOT was significantly high in children over ten years of age, during winter and in those with acute rheumatic carditis. ASOT showed significant direct correlation with the number of attacks of tonsillitis (P&lt;0.05). Egyptian children have high ULN ASOT reaching 400 IU. This has to be taken into consideration when interpreting its values in suspected ARF. A rise in ASOT is less prominent in recurrent ARF compared to 1st attack, and acute and recurrent tonsillitis. Basal levels of ASOT increase with age but the pattern of increase during infection is not age dependent.<\/jats:p>","DOI":"10.4081\/pr.2012.e8","type":"journal-article","created":{"date-parts":[[2012,2,22]],"date-time":"2012-02-22T16:53:17Z","timestamp":1329929597000},"page":"e8","source":"Crossref","is-referenced-by-count":23,"title":["Antistreptolysin O Titer in Health and Disease: Levels and Significance"],"prefix":"10.3390","volume":"4","author":[{"given":"Alyaa Amal","family":"Kotby","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nevin Mamdouh","family":"Habeeb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahar","family":"Ezz El Arab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2012,2,9]]},"reference":[{"key":"ref1","first-page":"475","article-title":"Update on acute rheumatic fever. It still exists in remote communities","volume":"55","author":"Madden","year":"2009","journal-title":"Can Fam Physician"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S1473-3099(05)70267-X","article-title":"The global burden of group A streptococcal diseases","volume":"5","author":"Carapetis","year":"2005","journal-title":"Lancet Infect Dis"},{"key":"ref3","unstructured":"Acute Rheumatic Feverhttp:\/\/emedicine.medscape.com\/article\/333103-overview"},{"key":"ref4","first-page":"222","article-title":"Prevalence of rheumatic heart disease among school children in Alexandria, Egypt: a prospective epidemiological study","volume":"73","author":"Abdel-Moula","year":"1998","journal-title":"J Egypt Public Health Assoc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1007\/BF02859412","article-title":"Benzathine Penicillin G for Rheumatic Fever Prophylaxis: 2-Weekly Versus 4-Weekly Regimens","volume":"59","author":"Kassem","year":"1992","journal-title":"Indian J Pediatr"},{"key":"ref6","first-page":"183","article-title":"Assessment of rheumatic fever and rheumatic heart disease in the Children's hospital, Ain Shams University","volume":"3-4","author":"Kotby","year":"1996","journal-title":"Egypt J Pediatr"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0140-6736(05)66874-2","article-title":"Acute rheumatic fever","volume":"366","author":"Carapetis","year":"2005","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.1161\/01.CIR.0000037745.65929.FA","article-title":"Jones Criteria Working Group. Proceedings of the Jones criteria workshop","volume":"106","author":"Ferrieri","year":"2002","journal-title":"Circulation"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1542\/peds.101.1.86","article-title":"Antistreptolysin O and anti-deoxyribonuclease B titers: normal values for children ages 2 to 12 in the United States","volume":"101","author":"Kaplan","year":"1998","journal-title":"Pediatrics"},{"key":"ref10","first-page":"1068","article-title":"Anti-Streptolysin O Titers in Normal Healthy Children of 5-15 Years","volume":"40","author":"Sethi","year":"2003","journal-title":"Indian J Pediatr"},{"key":"ref11","series-title":"Harrison's Principle of Internal Medicine","first-page":"1340","article-title":"Rheumatic fever","author":"Kaplan","year":"2001"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1097\/00006454-200205000-00014","article-title":"Clinical use and interpretation of group A streptococcal antibody tests: A practical approach for the pediatrician or primary care physician","volume":"21","author":"Shet","year":"2002","journal-title":"Pediatr Infect Dis J"},{"key":"ref13","first-page":"302","article-title":"Guidelines for the diagnosis of rheumatic fever: Jones criteria, updated 1992","volume":"87","author":"Dajani","year":"1993","journal-title":"Circulation"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1086\/340949","article-title":"Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious disease Society of America","volume":"35","author":"Bisno","year":"2002","journal-title":"Clin Infect Dis"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1161\/01.CIR.21.4.598","article-title":"Antibody titers in acute rheumatic fever","volume":"21","author":"Wannamaker","year":"1960","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"938","DOI":"10.3346\/jkms.2005.20.6.938","article-title":"Asymptomatic infection by Streptococcus pyogenes in school children and diagnostic usefulness of antideoxyribonuclease B","volume":"20","author":"Kim","year":"2005","journal-title":"J Korean Med Sci"},{"key":"ref17","first-page":"26","article-title":"Evaluation and revaluation of upper limits of normal values of anti-streptolysin O and anti deoxyribonuclease B in Mumbai","volume":"119","author":"Karmakar","year":"2004","journal-title":"Indian J Med Res"},{"key":"ref18","first-page":"33","article-title":"Antistreptolysin O and antideoxyribonuclease B titres in blood donors and in patients with features of nonsuppurative sequelae of group A streptococcus infection in Tanzania","volume":"72","author":"Mhalu","year":"1995","journal-title":"E Afr Med J"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1007\/BF02185847","article-title":"Age-related variations in anti-streptococcal antibody levels","volume":"8","author":"Renneberg","year":"1989","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref20","first-page":"196","article-title":"Serum levels of antistreptolysin O in teenagers from Mexican urban and rural areas","volume":"55950","author":"Nava","year":"2008","journal-title":"Rev Alerg Mex"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1161\/CIRCULATIONAHA.109.191959","article-title":"Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics","volume":"119","author":"Gerber","year":"2009","journal-title":"Circulation"},{"key":"ref22","first-page":"213","article-title":"Streptococcus antibodies in a rural population and in patients with inflammatory rheumatic diseases","volume":"44","author":"Bosmansky","year":"1985","journal-title":"Z Rheumatol"},{"key":"ref23","series-title":"Bacterial and mycotic infections of man","first-page":"248","author":"McCarty","year":"1958"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1471-2261-5-11","article-title":"Antibiotics for the primary prevention of acute rheumatic fever: a meta-analysis","volume":"5","author":"Robertson","year":"2005","journal-title":"BMC Cardiovasc Disord"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1136\/bmj.39031.420637.BE","article-title":"Rheumatic fever and its management","volume":"333","author":"Cilliers","year":"2006","journal-title":"BMJ"},{"key":"ref26","first-page":"105","article-title":"Antistreptolysin O titer profile in acute rheumatic fever diagnosis","volume":"77","author":"Machado","year":"2001","journal-title":"J Pediatr"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/j.1440-1754.2005.00726.x","article-title":"New normal ranges of antistreptolysin O and antideoxyribonuclease B titres for Australian children","volume":"41","author":"Danchin","year":"2005","journal-title":"J Paediatr Child Health"},{"key":"ref28","first-page":"323","article-title":"The range of antistreptolysin-O titer among 3129 healthy individuals in winter and summer in Tehran, Iran","volume":"7","author":"Gharagozloo","year":"1976","journal-title":"Pahlavi Med J"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1440-1754.2005.00557.x","article-title":"Rheumatic fever: the relationship between clinical manifestations and laboratory tests","volume":"41","author":"Roodpeyma","year":"2005","journal-title":"J Paediatr Child Health"}],"container-title":["Pediatric Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.pagepress.org\/journals\/index.php\/pr\/article\/viewFile\/3553\/3401","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.pagepress.org\/journals\/index.php\/pr\/article\/viewFile\/3553\/5632","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2036-7503\/4\/1\/e8\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T03:28:21Z","timestamp":1644463701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7503\/4\/1\/e8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,9]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2012,1]]}},"alternative-id":["pr.2012.e8"],"URL":"https:\/\/doi.org\/10.4081\/pr.2012.e8","relation":{},"ISSN":["2036-7503"],"issn-type":[{"value":"2036-7503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,9]]}}}