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Mitral regurgitation may be related with previous streptococcal infection
M R Wahid1, M Yoshinaga, Y Nomura
1Department of Paediatrics, Faculty of Medicine, Kagoshima University, Japan.
Unlabelled:
We measured anti M protein antibody (AMPA) titres in children with idiopathic mitral regurgitation (MR), streptococcal infection, rheumatic fever (RF), post-streptococcal acute glomerulonephritis (AGN) and normal healthy children. We investigated the association of MR with streptococcal infection and whether high AMPA titres can be used as persisting evidence of previous streptococcal infection. AMPA titres were measured with an enzyme-linked immunosorbent assay. We found significantly higher antibody titres in patients with MR and in streptococcal infection, RF, and AGN than in healthy controls. In the MR group (n = 15), 54% patients had AMPA titres above the 90th percentile value that was found in normal controls. An elevated AMPA titre persisted for a long period even when the anti-streptolysin O titres had declined to normal in RF patients. Our data suggest that the high AMPA titres in MR should be further investigated to clarify the probable association with previous streptococcal infection.
Conclusion:
High AMPA titre is a risk factor for developing complications after streptococcal infection. Our serological evidence suggests that in some patients, MR may be related to previous streptococcal infection.
Insights
High anti-M protein antibody (AMPA) titres are linked to mitral regurgitation (MR) in children. This suggests a potential association between MR and prior streptococcal infections, warranting further investigation.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Immunology
Background:
- Idiopathic mitral regurgitation (MR) in children requires understanding its etiology.
- Streptococcal infections are known to cause various post-infectious complications.
Purpose of the Study:
- To investigate the association between anti-M protein antibody (AMPA) titres and MR in children.
- To determine if elevated AMPA titres can serve as persistent markers of previous streptococcal infection.
Main Methods:
- AMPA titres were measured using enzyme-linked immunosorbent assay (ELISA).
- Titres were compared between children with MR, streptococcal infection, rheumatic fever (RF), post-streptococcal acute glomerulonephritis (AGN), and healthy controls.
Main Results:
- Significantly higher AMPA titres were observed in children with MR, streptococcal infection, RF, and AGN compared to healthy controls.
- In the MR group, 54% had AMPA titres above the 90th percentile of controls.
- Elevated AMPA titres persisted longer than anti-streptolysin O titres in RF patients.
Conclusions:
- High AMPA titres may indicate a risk factor for complications following streptococcal infections.
- Serological evidence suggests a potential link between MR and previous streptococcal infection in some pediatric cases.