Abstract

Objective: It has been speculated that the streptococcal anti - carbohydrate A (anti-ACHO) antibody level can be used as a useful test in discrimination between rheumatic and non-rheumatic etiologies in patients with mitral or aortic regurgitation. The aim of this study was to investigate the diagnostic value of anti-ACHO antibodies in patients with rheumatic carditis.

Materials and Methods: There were 29 children with rheumatic carditis in the study group (Group 1) and it was divided into two groups (Group 1A included the patients whose blood samples were taken in the first year of initial diagnosis and Group 1B included the patients whose blood samples were taken after the first year of diagnosis). Healthy 48 children were taken into the control group (Group 2). All blood samples taken from both groups were tested for anti-streptolysine-O (ASO), anti-deoxyribonuclease B (anti-DNAse B) and anti-ACHO antibody.

Results: The mean anti-ACHO level in Group 1A (2.96±0.55) was significantly higher than that in the control group (2.61±0.42) (p=0.001), but not different than that of Group 1B (2.69±0.37) (p=0.062). Also, the mean anti-ACHO level in Group 1B was not statistically significant compared to control group (p=0.677). This finding indicates that although the high anti-ACHO levels persist during the first year of initial diagnosis, they appear to be comparable to those of the control group after the first year.

Conclusion: We suggest that the anti-ACHO antibody can be used for diagnosis of active rheumatic carditis. But the decrease in antibody level after the first year may indicate that the factors determi ning the genetic susceptibility to rheumatic fever can be different in our population.