전신성류마티스질환에서 Anti-streptolysin O 검사의 재평가
Re-evaluation of the Anti-streptolysin O Test for Systemic Rheumatic Diseases
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Anti-streptolysin O (ASO) test is usually used to diagnose group A streptococcal infection-related diseases, such as rheumatic fever,reactive arthritis, and various infectious diseases. Despite the recent declining incidence of these diseases, ASO test is still frequently performed as a screening test to diagnose rheumatic diseases. This study re-evaluated the clinical usefulness of ASO test in systemic rheumatic diseases (SRD). Methods: ASO tests was performed in 825 patients between April and October in 2010. ASO levels were compared between SRD and non-SRD groups of patients. The results of ASO, C-reactive protein (CRP), and rheumatoid factor (RF) were compared among 6 subgroups of SRD: rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Behçet disease, Sjögren’s syndrome and others. Results: Positive results in ASO test (>200 IU/mL) were observed in 15.3% (126/825) of the patients tested. None of the ASO positive patients was, however, diagnosed with rheumatic fever or reactive arthritis. There were no statistically significant differences in the mean value (P =0.688)or positive rate (P =0.835) of ASO test between SRD and non-SRD groups. Positive rates of ASO test were also not statistically significant different among six subgroups of SRD patients (all P >0.05), whereas those of CRP and RF tests were significantly different. Conclusions: The usefulness of ASO test is very low for diagnosing SRD, although it is frequently carried out as a screening test. We suggest that ASO test must be performed selectively when diseases from group A streptococcal infection are suspected.
Abstract
Background: Anti-streptolysin O (ASO) test is usually used to diagnose group A streptococcal infection-related diseases, such as rheumatic fever,reactive arthritis, and various infectious diseases. Despite the recent declining incidence of these diseases, ASO test is still frequently performed as a screening test to diagnose rheumatic diseases. This study re-evaluated the clinical usefulness of ASO test in systemic rheumatic diseases (SRD). Methods: ASO tests was performed in 825 patients between April and October in 2010. ASO levels were compared between SRD and non-SRD groups of patients. The results of ASO, C-reactive protein (CRP), and rheumatoid factor (RF) were compared among 6 subgroups of SRD: rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Behçet disease, Sjögren’s syndrome and others. Results: Positive results in ASO test (>200 IU/mL) were observed in 15.3% (126/825) of the patients tested. None of the ASO positive patients was, however, diagnosed with rheumatic fever or reactive arthritis. There were no statistically significant differences in the mean value (P =0.688)or positive rate (P =0.835) of ASO test between SRD and non-SRD groups. Positive rates of ASO test were also not statistically significant different among six subgroups of SRD patients (all P >0.05), whereas those of CRP and RF tests were significantly different. Conclusions: The usefulness of ASO test is very low for diagnosing SRD, although it is frequently carried out as a screening test. We suggest that ASO test must be performed selectively when diseases from group A streptococcal infection are suspected.
참고문헌 (18)
- Shulman ST, "Group A streptococcal pharyngitis and immune-mediated complications: from diagnosis to management", Expert Rev Anti Infect Ther, 8, pp.137~150 (2010)
- Carapetis JR, "Acute rheumatic fever", Lancet, 366, pp.155~168 (2005)
- Logan D, "Poststreptococcal reactive arthritis", J am Podiatr Med Assoc, 96, pp.362~366 (2006)
- Moorthy LN, "Poststreptococcal reactive arthritis in children: a retrospective study", Clin Pediatr, 48, pp.174~182 (2009)
- Brahmadathan KN, "Microbiological diagnosis of streptococcal pharyngitis: lacunae and their implications", Indian J Med Microbiol, 24, pp.92~96 (2006)
- Jansen TL, "Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever", J Intern Med, 245, pp.261~267 (1999)
- Robertson KA, "Antibiotics for the primary prevention of acute rheumatic fever: a meta-analysis", BMC Cardiovasc Disord, 5, pp.11~ (2005)
- Steer AC, "Prevention and treatment of rheumatic heart disease in the developing world", Nat Rev Cardiol, 6, pp.689~698 (2009)
- Inglis TJ, "Decline in rheumatic fever", Lancet, 2, pp.1005~1006 (1985)
- Jose VJ, "Declining prevalence of rheumatic heart disease in rural schoolchildren in India: 2001-2002", Indian Heart J, 55, pp.158~160 (2003)
- Olguntürk R, "Rheumatic heart disease prevalence among schoolchildren in Ankara, Turkey", Turk J Pediatr, 41, pp.201~206 (1999)
- Visser H, "The diagnostic value of streptococcal serology in early arthritis: a prospective cohort study", Rheumatology, 39, pp.1351~1356 (2000)
- Waits JB, "Rational use of laboratory testing in the initial evaluation of soft tissue and joint complaints", Prim Care, 37, pp.673~689 (2010)
- Omurzakova NA, "High incidence of rheumatic fever and rheumatic heart disease in the republics of Central Asia", Int J Rheum Dis, 12, pp.79~83 (2009)
- Veasy LG, "Resurgence of acute rheumatic fever in the intermountain area of the United States", N Engl J Med, 316, pp.421~427 (1987)
- Danchin MH, "New normal ranges of antistreptolysin O and antideoxyribonuclease B titres for Australian children", J Paediatr Child Health, 41, pp.583~586 (2005)
- Ayoub EM, "Group A streptococcal antibodies in subjects with or without rheumatic fever in areas with high or low incidences of rheumatic fever", Clin Diagn Lab Immunol, 10, pp.886~890 (2003)
- Cha SH, "Upper limit of normal value for antistreptolysin O titer of healthy children in Seoul", J Korean Pediatr Soc, 38, pp.1061~1068 (1995)