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Rheumatic Fever Questions

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: dcbathe
  • August 3, 2009
  • 03:20 PM


My wife has developed acute pain in her wrist, knee, plams, fingers etc after 2 months after delivery. This is a rotating pain. Sometimes there is pain in wrist, next day in plams and so on.

Doctor asked us to do ASO test. Test has reading of 306 which is more than the normal level which is written as 200 in that report. After seeing that report doctor said that this might be because of Rheumatic Fever. But she had not faced any symptoms of that like throat infection or any fever in the last 1 month.

Is there any other reason for the ASO test to come as positive? Her age is 26yrs. Are there any chances of the Rheumatic Fever?



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3 Replies:

  • A positive ASO titer usually indicates production of antibodies in response to an infection with streptococci of the Group A beta-hemolytic type. ASO titer is generally not elevated in streptococcal skin infections. False positive ASO titers may result from other conditions such as liver disease or rheumatoid arthritis or due to contamination with other bacterial products. An elevated ASO titer may also be seen in healthy carriers. So, to answer your first question, although a positive ASO titer usually indicates an antecedent or current infection like strep throat, there is a possibility that the test can come positive without a person having strep throat. Your second question concerns the "chances of rhematic fever." There is no single test that gives a diagnosis of RF. Basically, evidence of preceding strep throat is taken as a starting point (and this may be confirmed with pharyngeal and blood cultures) and the presence of clinical criteria for RF such as migratory polyarthritis, carditis, erythema marginatum, etc. is considered diagnostic clinically. Further tests such as electrocardiography or echocardiography may be done to look for pancarditis. Also note that while RF "classically" occurs in individuals 5-15 yrs of age, it can also occur at older ages.
    m3dh31p 69 Replies Flag this Response
  • I am not a doctor or in the medical field at all but have been told that I had undiagnosed RH at some point in my life. I do recall having strep throat in my early 20's. My point is....Do Not let this go unchecked...Due to mine being left untreated (antibiotics for a year in the case of RH or several couses of anitbiotics for the strep throat) I am afflicted with mitral stenosis and am facing valve replacement surgery within the next year or so. I am 45 years old and already have had a valvuloplasty procedure that went less than well. My lungs fill with fluid because my body thinks im in heart failure now because my valve doesnt close and I have what they call mitral regurge......If I had know the repercussions of thinking im too tough to be really sick.....I would have made sure to take as many pills and see as many doctors until I was 100% better according to blood tests and not just my thinking that I was fine....Good health to you and make sure your wife insists on a clean bill of heath according to tests.
    Anonymous 42,789 Replies Flag this Response
  • Hi Dattatraya, First of all, a normal titre in an adult is less than 330, so your wife has within normal limits of ASO, although it is towards the higher side. Secondly, this can rise in many different infections of streptococcal group A (or strep. Pyogenes). An ASO titre will rise about 7 days after infection, peak at 3-5 weeks and gradually return to normal over the next 6-12 months. This means your wife could have been infected anytime in the last few months and it could have been an infection of the throat, kidneys, reactive arthritis, rheumatic fever, even some psychiatric illnesses like tourettes and Sydenham’s chorea can affect the levels.The results can also be affected by hyperbetalipoproteinemia, high cholesterol, hyperglobulinemia, lipemic serum and liver disorders. The symptoms you have described are called migratory polyarthritis and there are many causes for this too; rheumatic fever, infectious arthritis, palindromic arthritis, lyme disease, viruses, HIV, Hepatitis B & C, Sarcoidosis, Lupus, bacterial endocarditis.Chances of getting rheumatic fever is more likely if you are from a developing country or are a child or young adult but you can still get it if you are out of those risk factors.I would give your doctor a chance to do a few more tests and repeat the ASO test.
    Anonymous 42,789 Replies
    • November 3, 2009
    • 09:11 AM
    • 0
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