Detection of anti- DNase B antibody upper normal values in children's age groups who were admitted to hospital with noninfectious reasons

Abstract

OBJECTIVE:Anti-streptolysin O (ASO) and anti-DNase B (ADB) titers are used for the diagnosis of poststreptococcal complications. Ranges of normal values of ASO and ADB titers vary, depending on age, population and different time intervals. Although many studies have been performed for determination of the ASO titer in our country, only a few studies have been conducted for specification the upper limit of normal for (ULN) ADB. In our study we aimed to determine the upper limit of normal of ADB antibody titers in children aged 5–15.METHODS:One hundred and twenty one children aged from 5–15 who were admitted to our outpatient clinic of Haydarpaşa Numune Training and Research Hospital with noninfectious reasons between November 2013 and March 2014 were included in the study. Patients who met the following criteria were included in the study; absence of streptococcal infection in the last three months in physical examination and/or no growth of group A, C, and G of beta-haemolytic streptococci in throat culture, normal ranges of ASO and C reactive protein (CRP) levels. All serum samples were analyzed collectively by nephelometric method. The upper limit of normal value for anti-DNase B has been defined by separating the upper 20% from the lower 80% of all measurements.RESULTS:Anti-DNase B antibody levels were ranged between 50–576 IU/ml and its upper limit was 219.2 IU/ml. When analyzed according to age groups, anti-DNase B antibody levels in the group aged between 5–10, ranged between 50–576 IU/ml and its upper limit was 212.2 IU/ml, anti-DNase B antibody levels in the group aged 10–15, ranged between 50–408 IU/ml and its upper limit was 231.2 IU/ml (p=0.008).CONCLUSION:Based on our results, upper normal values ADB antibody showed variations with age in our results. Therefore national reference values should be detected by more comprehensive studies.

Comparison of antistreptolysin O and anti-deoxyribonucleic B titers in healthy children to those with acute pharyngitis, acute rheumatic fever, and rheumatic heart disease aged 5–15 years

“…There is a scarcity of literature on the ABD titers from India in healthy children. In normal healthy control group, median ADB titer was 78.25 IU/ml (53.395–128.150 IU/ml) in our study as against 123.6 IU/ml and 163 IU/ml, respectively, as reported by Delice et al [10] and Danchin et al [8]…”

“…There are several factors that influence ASO and ADB titers and thus the ULN values such as age, geographical location, seasonal variation, site of infection, and antibiotic treatment. [1] This is well evident by the reported values in different studies by Sethi et al ,[7] Danchin et al ,[8] Kotby et al ,[9] and Delice et al [10] in Table 1.…”

Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet

“…Serologies and cultures were only taken when considered clinically motivated, which may be considered as a limitation. Antistreptococcal antibody titers were not part of the protocol since they may be elevated in many preschool and school children who are frequently exposed to streptococci in everyday life and their validity is therefore disputed (Delice et al 2015). In an attempt to select a strictly defined cohort and minimize risk of misdiagnosis, we did not include patients who did not exhibit any kind of somatic symptom or sign.…”

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

“…The exacerbation of symptoms must be associated with the infection of group A Streptococci, which needs to be confirmed with the positive swab from the throat and/or increased titers of antistreptolysin-O (ASO) or anti-DNase B [56,57]. In the case of PANDAS, GAS infection usually occurs without macroscopic changes in the throat and symptoms of pharyngitis.…”