Test ID: SABP
Streptococcal Antibodies Profile
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Demonstration of acute or recent streptococcal infection
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ASO | Antistrep-O Titer, S | No | Yes |
| ADNAS | Anti-DNase B Titer, S | No | Yes |
Method Name A short description of the method used to perform the test
Nephelometry
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Anti-Dnase B
Anti-Hyaluronidase (possible equivalent test)
Antideoxyribonuclease B (ADB)
Antideoxyribonuclease
Antistreptolysin-O (ASO) Titer
ASO (Antistreptolysin-O) Titer
DNA Streptococcal Antibody
DNase-B, Anti
Hyaluronidase (possible equivalent test)
Streptococcal Antibodies, Serum
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross OK |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
A number of bacterial antigens have been identified in cultures of group A streptococci. These extracellular products are primarily enzymatic proteins and include streptolysin O, streptokinase, hyaluronidase, deoxyribonucleases (DNases A, B, C, and D), and nicotinamide adenine nucleotidase.
Infections by the group A streptococci are unique because they can be followed by the serious nonpurulent complications of rheumatic fever and glomerulonephritis. Recent information suggests that rheumatic fever is associated with infection by certain rheumatogenic serotypes (M1, M3, M5, M6, M18, and M19), while glomerulonephritis follows infection by nephritogenic serotypes (M2, M12, M49, M57, M59, and M60).
Glomerulonephritis and rheumatic fever occur following the infection, after a period of latency following the infection, during which the patient is asymptomatic. The latency period for glomerulonephritis is approximately 10 days, and for rheumatic fever the latency period is 20 days.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
ANTISTREP-O TITER
<5 years: < or =70 IU/mL
5-17 years: < or =640 IU/mL
> or =18 years: < or =530 IU/mL
ANTI-DNase B TITER
<5 years: < or =250 U/mL
5-17 years < or =375 U/mL
> or =18 years: < or =300 U/mL
Interpretation Provides information to assist in interpretation of the test results
Elevated values are consistent with an antecedent infection by group A streptococci.
Although the antistreptolysin O (ASO) test is quite reliable, performing the anti-DNase is justified for 2 primary reasons. First, the ASO response is not universal. Elevated ASO titers are found in the sera of about 85% of individuals with rheumatic fever; ASO titers remain normal in about 15% of individuals with the disease. The same holds true for other streptococcal antibody tests: a significant portion of individuals with normal antibody titers for 1 test will have elevated antibody titers for another test. Thus, the percentage of false-negatives can be reduced by performing 2 or more antibody tests. Second, skin infections, in contrast to throat infections, are associated with a poor ASO response. Patients with acute glomerulonephritis following skin infection (post-impetigo) have an attenuated immune response to streptolysin O. For such patients, performance of an alternative streptococcal antibody test is recommended.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
The use of the antistreptolysin O (ASO) for the diagnosis of an acute group A streptococcal infection is rarely indicated, unless the patient has received antibiotics that would render the culture negative. There are certain limitations to the use of the ASO test in these circumstances due to the delay and attenuation of the immune response following early antibiotic therapy.
False-high titers may be obtained with sera that are contaminated by certain bacterial organisms during shipment or storage and in patients with liver disease where the presence of high lipoprotein concentrations in the serum may mimic antibody activity.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Ayoub EM, Harden E: Immune response to streptococcal antigens: diagnostic methods. In Manual of Clinical and Laboratory Immunology. 5th edition. Edited by NR Rose, EC de Marco, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 450-457
Method Description Describes how the test is performed and provides a method-specific reference
Nephelometry. Polystyrene particles are coated with streptolysin O and DNase B antigens. The serum specimens containing antibodies will complex with the antigens, forming aggregations that will scatter light. The intensity of the resulting scattered light in the nephelometer is dependent upon the antibody content in the specimen. Calculations are based on the comparison of the specimens to standards of known concentrations. (Pacifico L, Mancuso G, Properzi E, et al: Comparison of nephelometric and hemolytic techniques for determination of antistreptolysin O antibodies. Am J Clin Pathol 1995 April;103[4]:396-399)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; Continuously until 3 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86060-Antistreptolysin O, titer
86215-Deoxyribonuclease, antibody
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| ADNAS | Anti-DNase B Titer, S | 5133-4 |
| ASO | Antistrep-O Titer, S | 5370-2 |
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