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The group specific polysaccharide antibody in children with non-suppurative sequelae of group A streptococcal

H A Majeed1, A M Yousof, J Pokorny

  • 1Departments of Pediatrics, Medicine, Mircobiology, Faculty of Medicine, University of Kuwait, and the WHO Center for Reference and Research on Streptococci, Prague, Czechoslovakia.

Annals of Saudi Medicine
|January 1, 1993
PubMed

Insights

Children with rheumatic heart disease showed higher group A specific polysaccharide antibody titers at onset and during follow-up compared to those with rheumatic fever without carditis or poststreptococcal nephritis.

Area of Science:

  • Pediatrics
  • Immunology
  • Rheumatology

Background:

  • Acute rheumatic fever (ARF) is an inflammatory disease following streptococcal infection.
  • Rheumatic heart disease (RHD) is a serious complication of ARF.
  • Group A specific polysaccharide antibody kinetics can indicate disease activity and progression.

Purpose of the Study:

  • To investigate the kinetics of group A specific polysaccharide antibody in children with ARF.
  • To compare antibody titers between children with ARF with and without carditis.
  • To differentiate antibody responses in ARF/RHD from poststreptococcal glomerulonephritis.

Main Methods:

  • Study included children with ARF (no carditis), ARF with carditis (developing RHD), and poststreptococcal glomerulonephritis.
  • All ARF patients received continuous antistreptococcal prophylaxis.
  • Group A specific polysaccharide antibody titers were measured at onset and during follow-up (mean 3 years).

Main Results:

  • Children who developed RHD had significantly higher antibody titers at onset compared to ARF without carditis (P=0.01).
  • A high antibody titer was maintained in RHD patients throughout the follow-up period.
  • Follow-up titers in RHD patients were significantly higher than in ARF without carditis and poststreptococcal nephritis groups (P=0.001 for both).

Conclusions:

  • Elevated group A specific polysaccharide antibody titers are associated with the development of carditis in acute rheumatic fever.
  • Sustained high antibody titers may indicate ongoing inflammation or risk in children with rheumatic heart disease.
  • Antibody kinetics can aid in distinguishing ARF/RHD from other post-streptococcal conditions.

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