OBJECTIVE: Acute Rheumatic Fever (ARF) affects millions children in developing
countries. The diagnosis of ARF is based on the Jones criteria and supporting
evidence of preceding streptococcal infection from a positive throat culture or
elevated Anti Streptolysin O (ASO) titers. The objective of this study was to
determine the role of single ASO titer in correlation with Jones major criteria for
diagnosis of ARF.
METHOD: This cross sectional study evaluated medical records of children less than
18 years old diagnosed with ARF at Dr. Soetomo Academic General Hospital,
Surabaya from 2016 to 2018. The diagnosis of ARF was based on the presence of
two major, or one major and two minor manifestations and must be accompanied by
supporting evidence of antecedent group A streptococcal infection in the form of
positive throat culture or elevated or rising ASO titer based on Jones criteria. The
measurement of ASO titers was performed through latex agglutination nephelometric
assay, recorded positive if the titer above 200 IU/ml. Fisher’s exact test were used to
analyzed, with p<0.05 considered significant.
RESULT: There were 55 ARF children, 54% were boys. The youngest child was 6
years old and the oldest was 16 years old. The ASO titers levels ranged from 50 to
800 IU/ml, ASO titers positive was found in 87% children. 18/20 children with both
presenting carditis and polyarthritis had ASO titers positive. Unfortunately children
who had only carditis or polyarthritis had ASO titers positive in 29/35 cases
(p=0.043).
CONCLUSION: A single ASO titer retains its role as a useful diagnostic tool for ARF.